Negotiating Relational Practice Patterns in Palliative Home Care

Author:

Ward-Griffin Catherine1,McWilliam Carol2,Oudshoorn Abram2

Affiliation:

1. C Ward-Griffin (corresponding author): Faculty of Health Sciences, Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada N6A 5C1;

2. C McWilliam, A Oudshoorn: Faculty of Health Sciences, Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada

Abstract

Providing palliative care in the home presents a variety of challenges for nurses and other care providers. As part of a focused ethnographic study examining client/caregiver/care-provider relationships within the socio-cultural context of home-based palliative care, this paper describes the provision of palliative care to Canadian seniors with advanced cancer from the perspective of nurses. Data were collected through in-depth interviews (n=19) with three palliative care nurses and participant observations in four households over a six-to-eight-month period. Home-based palliative care nursing was depicted in this study as a dialectical experience, revealing three relational practice patterns: making time-forfeiting time, connecting-withdrawing, and enabling-disabling. Nurses attempted to negotiate the tensions between these opposing approaches to palliative care. Study findings suggest that the socio-cultural context of palliative care is not conducive to high-quality palliative care and provide several insights related to future directions for practice, policy, and research.

Publisher

SAGE Publications

Subject

General Medicine

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