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Meanings of being a close relative of a family member treated with haemodialysis approaching end of life
Author(s) -
Axelsson Lena,
Klang Birgitta,
Lundh Hagelin Carina,
Jacobson Stefan H,
Gleissman Sissel Andreassen
Publication year - 2015
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.12622
Subject(s) - end of life care , quality of life (healthcare) , harm , family member , qualitative research , medicine , palliative care , interpretative phenomenological analysis , nursing , psychology , end stage renal disease , relevance (law) , family medicine , social psychology , hemodialysis , psychiatry , sociology , social science , political science , law
Aims and objectives To describe and elucidate the meanings of being a close relative of a severely ill family member treated with maintenance haemodialysis approaching the end of life. Background End‐stage renal disease together with comorbidities, haemodialysis treatment and high mortality rates also affects the lives of close relatives, who report burdens and impaired quality of life. To improve care, more understanding is needed of close relatives' experiences during these patients' end of life. Design This study has a qualitative interpretative design. Methods Fourteen retrospective qualitative interviews were conducted with close relatives (aged 48–93 years) of deceased patients who had been treated with haemodialysis. The interview text was interpreted using a phenomenological hermeneutical method in three phases. Results The findings of the structural analysis were formulated as six themes: Striving to be supportive and helpful without doing harm to the ill person's self; Needing increasing strength and support; Balancing the will to help with one's own ongoing life; Increasing responsibility involving dilemmas; Striving for a good life together in the present and Living with awareness of death . Conclusions Close relatives strive for balance and well‐being accompanying their ill family member through the end of life. They are facing moral dilemmas and growing demands as their responsibility increases with the deterioration of their family member. Support from and interaction with the healthcare professionals is then of significance. Relevance to clinical practice Findings challenge healthcare professionals in haemodialysis settings to identify close relatives' individual resources and needs towards the patients' end of life. Healthcare professionals in haemodialysis settings need to offer close relatives opportunities to talk about the future and what may be expected at end of life, with or without haemodialysis. They should also contact the closest relative after the death as they may need confirmation and closure.