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Meeting in a 'free-zone': Clinical ethical support in integrated heart-failure and palliative care
Department of Nursing, Umeå University, Sweden. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
Department of Nursing, Umeå University, Sweden.
Luleå University of Technology, Department of Health Sciences, Nursing Care. Norrbotten County Council, Sweden.ORCID iD: 0000-0001-5953-8970
Department of Nursing, Umeå University, Sweden.
2019 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 7, p. 577-583Article in journal (Refereed) Published
Abstract [en]

Background: Integrating heart-failure and palliative care combines expertise from two cultures, life-saving cardiology and palliative care, and involves ethically difficult situations that have to be considered from various perspectives. We found no studies describing experiences of clinical ethical support (CES) in integrated cardiology and palliative care teams.Objective: Our aim is to describe experiences of CES among professionals after a period of three years working in a multidisciplinary team in integrated heart-failure and palliative homecare.Method: The study design was descriptive qualitative, comprising interviews with seven professionals from one integrated heart-failure and palliative care team who received CES over a three-year period. The interview data were subjected to qualitative content analysis.Results: The CES was found to offer possibilities for meeting in an ethical ‘free-zone’ where the participants could relate to each other beyond their various professional roles and specialties. The trust within the team seemed to increase and the participants were confident enough to express their points of view. Together they developed an integrated understanding, and acquired more knowledge and a comprehensive view of the ethically difficult situation of concern. The CES sessions were considered a means of becoming better prepared to deal with ethical care issues and developing action strategies to apply in practice, from shared standpoints.Conclusion: Participating in CES was experienced as meeting in an ethical ‘free-zone’ and seemed to be a means of facilitating integration of palliative and heart-failure care.

Place, publisher, year, edition, pages
Sage Publications, 2019. Vol. 18, no 7, p. 577-583
Keywords [en]
Clinical ethical support, heart failure, implementation, palliative care, PREFER study, RiFECC
National Category
Nursing
Research subject
Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-74598DOI: 10.1177/1474515119851621ISI: 000487801400008PubMedID: 31088300Scopus ID: 2-s2.0-85072628164OAI: oai:DiVA.org:ltu-74598DiVA, id: diva2:1325657
Note

Validerad;2019;Nivå 2;2019-10-02 (johcin)

Available from: 2019-06-17 Created: 2019-06-17 Last updated: 2019-10-10Bibliographically approved

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Zingmark, Karin

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