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  • 1. Axelsson, Karin
    et al.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Häggström, Terttu
    Iranmanesh, Sedigheh
    Project: Caring for dying and meeting death. The views of Iranian and Swedish nurses and nurse students2010Other (Other (popular science, discussion, etc.))
  • 2.
    Iranmanesh, Sedigheh
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Caring for dying and meeting death: the views of Iranian and Swedish nurses and student nurses2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Nurses play a principal role in the caring for dying persons and their families. Increasing diversity and globalisation demand culturally sensitive and competent health personnel who have scientifically based knowledge about the universal phenomenon of death and dying. A mixed method of research was conducted to describe student nurses' and nurses' views of caring for dying people in the cultural contexts of Iran and Sweden. In the first part, a quantitative method with two questionnaires (FATCOD and DAP-R) was used to examine the student nurses' and registered nurses' attitudes towards death and caring for dying persons in Iran. In the second part, a phenomenological hermeneutic approach was used to illuminate the meaning of nurses' experiences with the caring for dying persons in the cultural contexts of Iran and Sweden. According to the results (I, II), student nurses' and nurses' attitudes towards caring for dying people were influenced by their attitudes towards death, education, previous experience with death, and previous experience of caring for a dying relative. Iranian nurses were unlikely to talk about death with dying persons and their families. The findings of the qualitative part indicate that professional care for dying people is a lifelong learning process that takes place in a sociocultural context (III, IV). The Iranian and Swedish registered nurses' experiences showed similarities that crossed cultures. The existential context for their care was almost identical. The nurses met people and their families at the end of their lives. Being invited to share the understanding of this unique experience raised an ethical demand to care within close relationships. It called for a personal and professional response in all aspects. Swedish nurses preserved patients' dignity by meeting personal caring needs according to each person's preferences as well as providing each person with appropriate information. Iranian nurses were also concerned about each person's dignity, although they were not allowed to inform persons and family members about a person's real condition. They believed that such information could hasten the patient's death. Swedish nurses regularly used teamwork. Team reflective practices were important in the support of their professional development. The study revealed that Iranian nurses lacked collaboration between nurses and other professionals, including social workers. The results suggest that student nurses and nurses should be offered the opportunity to reflect on their experiences, feelings, actions, and reactions to death, as well as caring for dying people and their families. This could be accomplished at work or in professionally guided individual or group sessions. Such supervision could transform their personal experiences into positive and constructive learning. Recognition of the common foundation behind different cultures, religions, and nurses' own caring behaviours could support the universal phenomenon of care as a human mode of being, in order to be able to provide culturally sensitive and competent and supportive care to patients with various cultural backgrounds. General educational programmes and programmes dealing with end of life care must focus on to the fact that patients' and family members are unique beings with unique backgrounds and preferences. Specific training programmes should aim at increasing an understanding among professional carers about what shape patients' world views in order to support their dignity and well-being at the end of life.

  • 3. Iranmanesh, Sedigheh
    et al.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    A caring relationship with persons who have cancer2009In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, no 6, p. 1300-1308Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study conducted to elucidate the meaning of a caring relationship with people with cancer.Background. A caring relationship becomes the most important focus of caregiving when treatment of the body has reached the limits where cure is no longer expected. Caring as perceived by people with cancer involves nurses having professional attitudes and skills in order to provide good care, including emotional and practical support.Methods. A phenomenological hermeneutic approach influenced by Ricoeur was used. Eight nurses working in an oncology unit in Iran were interviewed in 2007 about their experiences of caring relationships with people who have cancer.Findings. The findings were interpreted as getting involved in a mutual/demanding close relationship. Closeness demanded nurses to be present, to listen to patients, and to be compassionate. Closeness was also mutual and characterized both caregiving and receiving new insights into values in the nurses' own lives. The close relationship was at times frustrating when they were faced with situations that they could not handle and were out of their control.Conclusion. Closeness is an important foundation for caring, and acquires a special dimension in the care of people with cancer and their relatives. It derives from the personal and professional experiences of nurses in their own life stories. Nursing education should include a reflective approach in order to develop caring skills in oncology nursing that are not merely attuned to medical care.

  • 4. Iranmanesh, Sedigheh
    et al.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Häggström, Terttu
    Caring for dying and meeting death: experiences of Iranian and Swedish nurses2010In: Indian Journal of Palliative Care, ISSN 0973-1075, E-ISSN 1998-3735, Vol. 16, no 2, p. 90-96Article in journal (Refereed)
    Abstract [en]

    Objective: Our world is rapidly becoming a global community, which creates a need to further understand the universal phenomena of death and professional caring for dying persons This study thus was conducted to describe the meaning of nurses' experiences of caring for dying people in the cultural contexts of Iran and Sweden. Materials and Methods: Using a phenomenological approach, phenomenon of caring for dying people was studied.Eight registered nurses who were working in oncology units in Tehran, Iran and eight registered nurses working in hospital and home care in North part of Sweden were interviewed. The interviews were analyzed using the principles of phenomenological hermeneutics. Results: The findings were formulated based on two themes included: (1) "Sharing space and time to be lost", and (2) "Caring is a learning process Conclusions: The results showed that being with dying people raise an ethical demand that calls for personal and professional response, regardless of sex, culture or context The physical and organizational context must be supportive and enable nurses to stand up to the demands of close relationships Specific units and teamwork across various personnel seem to be a solution that is missing in Iran.

  • 5.
    Iranmanesh, Sedigheh
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Dargahi, Helen
    Valiasr Hospital, Tehran University of Medical Science.
    Abbaszadeh, Abbas
    Kerman University of Medical Sciences, Faculty of Nursing and Midwifery.
    Attitudes of Iranian nurses toward caring for dying patients2008In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 6, no 4, p. 363-369Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the attitudes of Iranian nurses toward caring for dying patients.Methods: Nurses' attitudes toward death and caring for dying patients were examined by using two types of questionnaires: the Death Attitude Profile-Revised (DAP-R) and Frommelt's Attitude towards Caring for Dying Patients (FATCOD), both with a demographic survey.Results: The results showed that most respondents are likely to view death as a natural part of life and also as a gateway to the afterlife. The majority reported that they are likely to provide care and emotional support for the people who are dying and their families, but they were unlikely to talk with them or even educate them about death. They had a tendency not to accept patients and their families as the authoritative decision makers or involve families in patient care. Nurses' personal views on death, as well as personal experiences, affected their attitudes toward care of the dying.Significance of results: Lack of education and experience, as well as cultural and professional limitations, may have contributed to the negative attitude toward some aspects of the care for people who are dying among the nurses surveyed. Creating a reflective narrative environment in which nurses can express their own feelings about death and dying seems to be a potentially effective approach to identify the factors influencing their interaction with the dying. Continuing education may be required for Iranian palliative care nurses in order to improve the patients quality of care at the end of life.

  • 6.
    Iranmanesh, Sedigheh
    et al.
    Kerman University of Medical Sciences, Faculty of Nursing and Midwifery.
    Ghazanfari, Zahra
    Kerman University of Medical Sciences, Faculty of Nursing and Midwifery.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Häggström, Terttu
    Narvik University College, 8505 Narvik, Norway.
    Professional development: Iranian and Swedish nurses' experiences of caring for dying people2011In: Journal of Palliative Care, ISSN 0825-8597, Vol. 27, no 3, p. 202-209Article in journal (Refereed)
    Abstract [en]

    Our world is rapidly becoming a global community. This creates a need for us to further understand the universal phenomena of death and professional care for dying persons. A transcultural study was undertaken using a phenomenological approach to illuminate the meaning of nurses' experiences of professional development in the contexts of Iran and Sweden. Eight registered nurses working in oncology units in Tehran, Iran, and eight working in the context of a hospital and private homes in northern Sweden were interviewed. The interviews were analyzed using the principles of phenomenological hermeneutics inspired by Paul Ricoeur. A naive reading guided a structural analysis, which yielded four main themes: coping with existential, organizational, and cultural contexts; sharing knowledge, experiences, and responsibilities; using embodied knowledge; and developing personal competence. The interpreted comprehensive understanding revealed that the meaning of professional development is that it actualizes other-oriented values and self-oriented values. Caring professionally for dying people was a learning process that could help nurses to develop their personal and professional lives when they were supported by teamwork, reflective practice, and counselling.

  • 7.
    Iranmanesh, Sedigheh
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Häggström, Terttu
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Caring for dying people: attitudes among Iranian and Swedish nursing students2010In: Indian Journal of Palliative Care, ISSN 0973-1075, E-ISSN 1998-3735, Vol. 16, no 3, p. 147-153Article in journal (Refereed)
    Abstract [en]

    Aim: To compare the attitudes of Iranian and Swedish nursing students toward caring for dying persons. Materials and Methods: Their attitudes were measured with the Frommelt′s Attitude Toward Caring of the Dying and the Death Attitude Profile Revised. Results: The results indicated that the participating Iranian students were more afraid of death and less likely to give care to dying persons than the Swedish participants. Conclusion: It is suggested that theoretical education should be individualized and culturally sensitive in order to positively influence the students′ attitudes, and promote professional development.

  • 8. Iranmanesh, Sedigheh
    et al.
    Häggström, Terttu
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Swedish nurses' experiences of caring for dying people: a holistic approach2009In: Holistic Nursing Practice, ISSN 0887-9311, E-ISSN 1550-5138, Vol. 23, no 4, p. 243-52Article in journal (Refereed)
    Abstract [en]

    Most people need to be cared for at the end of their lives by professionals. This study aimed to elucidate the meaning of nurses' experiences of caring for dying persons at home and in a special unit in a hospital. Four registered nurses working in private homes and 4 registered nurses working in a specific unit in a hospital setting were interviewed. The study was planned and carried out with a phenomenological hermeneutic approach. A naive reading guided a structural analysis, which resulted in 3 main themes: meeting patients and family members as unique persons, learning in a challenging environment, and gaining personal strength. The interpreted comprehensive understanding conveyed a meaning that caring for families with a member awaiting the end of life created a situation where the presence of an inevitable death demanded nurses to create close relationships with each unique person involved.

  • 9.
    Iranmanesh, Sedigheh
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Abbaszadeh, Abbas
    Kerman University of Medical Sciences, Faculty of Nursing and Midwifery.
    Student nurses' attitudes towards death and dying in south-east Iran2008In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 14, no 5, p. 214-219Article in journal (Refereed)
    Abstract [en]

    In this study, the attitudes of student nurses from Kerman and Bam in Iran towards death and caring for dying patients were compared. Two types of questionnaire were used: the DAP-R (Death Attitude Profile Revised) and FATCOD (Frommelt Attitude Towards Caring for Dying patients). The Bam student nurses, who had more experience of death due to the Bam earthquake in December 2003, were found to be less afraid of death and also less likely to give care to people at the end of life compared to their counterparts in Kerman. In both groups, those who were educated about death and dying had more positive attitudes towards caring for people who are dying than non-educated participants. The study suggests that adding palliative care education, accompanied by a reflective narrative approach, to the nursing curriculum is necessary to improve quality of care at the end of life.

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