“Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area

Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered...

Full description

Bibliographic Details
Main Authors: Siri Andreassen Devik, Ove Hellzen, Ingela Enmarker
Format: Article
Language:English
Published: Taylor & Francis Group 2015-09-01
Series:International Journal of Qualitative Studies on Health & Well-Being
Subjects:
Online Access:http://www.ijqhw.net/index.php/qhw/article/view/28382/42120
_version_ 1819056297369141248
author Siri Andreassen Devik
Ove Hellzen
Ingela Enmarker
author_facet Siri Andreassen Devik
Ove Hellzen
Ingela Enmarker
author_sort Siri Andreassen Devik
collection DOAJ
description Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered by general district nurses. This study aimed to illuminate the lived experience and to interpret the meaning of receiving home nursing care when being old and living with advanced cancer in a rural area in Norway. Narrative interviews were conducted with nine older persons, and a phenomenological hermeneutic approach was used to interpret the meaning of the lived experience. The analysis revealed three themes, each with subthemes: being content with what one gets, falling into place, and losing one's place. The phrase picking up the pieces was found useful to sum up the meaning of this lived experience. The three respective themes refer to how the pieces symbolize the remaining parts of life or available services in their environment, and how the older persons may see themselves as pieces or bricks in a puzzle. A strong place attachment (physical insideness, social insideness, and autobiographical insideness) is demonstrated by the informants in this study and suggests that the rural context may provide an advantageous healthcare environment. Its potential to be a source of comfort, security, and identity concurs with cancer patients’ strong desire for being seen as unique persons. The study shows that district nurses play an essential role in the provision of palliative care for older rural patients. However, the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner. Communication skills and attentiveness to psychosocial aspects of patient care stand out as important attributes for nursing in this context.
first_indexed 2024-12-21T13:21:10Z
format Article
id doaj.art-2a4c5acedad145d3b5c3916d63312b97
institution Directory Open Access Journal
issn 1748-2631
language English
last_indexed 2024-12-21T13:21:10Z
publishDate 2015-09-01
publisher Taylor & Francis Group
record_format Article
series International Journal of Qualitative Studies on Health & Well-Being
spelling doaj.art-2a4c5acedad145d3b5c3916d63312b972022-12-21T19:02:34ZengTaylor & Francis GroupInternational Journal of Qualitative Studies on Health & Well-Being1748-26312015-09-0110011010.3402/qhw.v10.2838228382“Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural areaSiri Andreassen Devik0Ove Hellzen1Ingela Enmarker2 Centre of Care Research, Mid-Norway, Steinkjer, Norway Department of Nursing, Mid-Sweden University, Sundsvall, Sweden Centre of Care Research, Mid-Norway, Steinkjer, NorwayRural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered by general district nurses. This study aimed to illuminate the lived experience and to interpret the meaning of receiving home nursing care when being old and living with advanced cancer in a rural area in Norway. Narrative interviews were conducted with nine older persons, and a phenomenological hermeneutic approach was used to interpret the meaning of the lived experience. The analysis revealed three themes, each with subthemes: being content with what one gets, falling into place, and losing one's place. The phrase picking up the pieces was found useful to sum up the meaning of this lived experience. The three respective themes refer to how the pieces symbolize the remaining parts of life or available services in their environment, and how the older persons may see themselves as pieces or bricks in a puzzle. A strong place attachment (physical insideness, social insideness, and autobiographical insideness) is demonstrated by the informants in this study and suggests that the rural context may provide an advantageous healthcare environment. Its potential to be a source of comfort, security, and identity concurs with cancer patients’ strong desire for being seen as unique persons. The study shows that district nurses play an essential role in the provision of palliative care for older rural patients. However, the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner. Communication skills and attentiveness to psychosocial aspects of patient care stand out as important attributes for nursing in this context.http://www.ijqhw.net/index.php/qhw/article/view/28382/42120Advanced cancerrural palliative carehomecaredistrict nursingold peopleidentityplace attachmentqualitative researchphenomenological hermeneutics
spellingShingle Siri Andreassen Devik
Ove Hellzen
Ingela Enmarker
“Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area
International Journal of Qualitative Studies on Health & Well-Being
Advanced cancer
rural palliative care
homecare
district nursing
old people
identity
place attachment
qualitative research
phenomenological hermeneutics
title “Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area
title_full “Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area
title_fullStr “Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area
title_full_unstemmed “Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area
title_short “Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area
title_sort picking up the pieces meanings of receiving home nursing care when being old and living with advanced cancer in a rural area
topic Advanced cancer
rural palliative care
homecare
district nursing
old people
identity
place attachment
qualitative research
phenomenological hermeneutics
url http://www.ijqhw.net/index.php/qhw/article/view/28382/42120
work_keys_str_mv AT siriandreassendevik pickingupthepiecesmeaningsofreceivinghomenursingcarewhenbeingoldandlivingwithadvancedcancerinaruralarea
AT ovehellzen pickingupthepiecesmeaningsofreceivinghomenursingcarewhenbeingoldandlivingwithadvancedcancerinaruralarea
AT ingelaenmarker pickingupthepiecesmeaningsofreceivinghomenursingcarewhenbeingoldandlivingwithadvancedcancerinaruralarea