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Humour and laughing in patients with prolonged incurable cancer - an ethnographic study in a comprehensive cancer centre

BUITING, Hilde M. ; DE BREE, Remco ; BROM, Linda ; MACK, Jennifer W. ; VAN DEN BREKEL, Michiel W. M.
Quality of life research, 06/04/2020, Pagination inconnue

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Thème : Soins.

CANCEROLOGIE ; HUMOUR ; PAYS-BAS ; ETHNOGRAPHIE

Purpose: Most people are familiar with the expression ‘laughter is the best medicine’. By enhancing cognitive flexibility and strengthening relationships, laughter can be considered a holistic care-approach. Yet, in medical oncology, especially the palliative phase, using humour can be considered inappropriate or taboo. We aimed to explore the acceptability and functions of humour and laughter in patients with prolonged incurable cancer.
Methods: This study was performed in a Dutch Comprehensive Cancer Centre. We included four short conversations with patients, eighteen in-depth patient-interviews and eleven observational fieldnotes in which humour was a major topic of the conversation. We further administered an online questionnaire to thirty-three oncology clinicians about their experiences with humour. Qualitative data were thematically analysed. We specifically distinguished between humour and laughter.
Results: Nearly all specialists reported using humour (97%), and all reported sometimes laughing during consultations; 83% experienced a positive effect of laughter. These results were in line with patients’ experiences: Patients noted that humour always stayed alive despite medical difficulties. Apart from this human aspect, patients also used humour to broach difficult topics and downplay challenges. Patients and specialists acknowledged that using humour is sometimes inappropriate, partly because they did not always share the same humour. Laughter, in contrast, was regarded as ‘lighter’ than humour, and could, accordingly, more easily be implemented. Specialists cautioned against patients using laughter to avoid broaching difficult topics.
Conclusion: Many conversations were full of laughter. Hierarchy as usually experienced between healthcare professionals and patients/relatives seemed to disappear when using laughter. If applied appropriately, adding shared laughter may help optimize shared decision-making.

Origine : DOI.org (Crossref

Living in the mo(ve)ment - an ethnographic exploration of hospice patients' experiences of participating in Tai Chi

BRADSHAW, Andy ; PHOENIX, Cassandra ; BURKE, Shauna M.
Psychology of sport and exercice, Elsevier, 07/2020, vol.49, pagination inconnue

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Women's work at end of life - the intersecting gendered vulnerabilities of patients and caregivers in rural Malawi

MKANDAWIRE-VALHMU, Lucy ; KENDALL, Nancy ; DRESSEL, Anne ; WENDLAND, Claire ; SCHEER, Victoria L. ; KAKO, Peninnah ; NEIMAN, Tammy ; VALHMU, Wilmot ; RUIZ, Ashley ; LUEBKE, Jeneile ; MINJALE, Peter ; MERRIMAN, Anne ; FINCH, Lucy ; EGEDE, Leonard
Global public health, 21/02/2020, p. 1-11

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Un cannibalisme symbolique mutuel entre vivants et défunts - une ethnographie de la fête des morts en Bolivie

GEFFROY, Céline
ETUDES SUR LA MORT, 2019, n°152, p. 101-115

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La vitalité des morts en mésoamérique - transferts alimentaires et construction du lien social

PITROU, Perig
ETUDES SUR LA MORT, 2019, n°152, p. 73-85

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Perspectives of elders and their adult children of black and minority ethnic heritage on end-of-life conversations - a meta-ethnography

DE SOUZA, Joanna ; GILLETT, Karen ; FROGGATT, Katherine ; WALSHE, Catherine
PALLIATIVE MEDICINE, 2020, vol.34, n°2, p. 195-208

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Strategies to improve quality of life at the end of life - interdisciplinary team perspectives

SAGHA ZADEH, Rana ; ESHELMAN, Paul ; SETLA, Judith ; SADATSAFAVI, Hessam
The American journal of hospice and palliative care, 03/2018, vol.35, n°3, p. 411-416

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The value of the ethnographic approach to research issues in palliative care

REIGADA, Carla ; SAPETA, Paula ; CENTENO, Carlos
Current opinion in supportive and palliative care, 12/2019, vol.13, n°4, p. 337-343

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(End of) life spaces - an ethnographic study in Brazilian and French homes and medical-social institutions

CORDEIRO, Franciele Roberta ; KRUSE, Maria Henriqueta Luce
Revista gaucha de enfermagem, 2019, vol.40, p. 1-9

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Soins et prison - enquête auprès de détenus gravement malades

CHASSAGNE, Aline
Erès , 11/2019 , 290 p.

Agitation near the end of life with dementia - an ethnographic study of care

SAMPSON, Elizabeth L. ; STRINGER, Aisling ; LA FRENAIS, Francesca ; HIGGINS, Shanlee ; DOYLE, Mary-Jo ; LAYBOURNE, Anne ; LIVINGSTON, Gill ; LEAVEY, Gerard
Plos one, 2019, vol.14, n°10, p. 1-19

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Thème : Médecine. Cote : eD03.01.01

AGITATION ; FIN VIE ; DEMENCE ; ETHNOGRAPHIE

BACKGROUND AND OBJECTIVES: Agitation is common in people living with dementia especially at the end of life. We examined how staff interpreted agitation behavior in people with dementia nearing end of life, how this may influence their responses and its impact on the quality of care.
RESEARCH DESIGN: Ethnographic study. Structured and semi-structured non-participant observations (referred to subsequently in this paper as "structured observations") of people living with dementia nearing the end of life in hospital and care homes (south-east England) and in-depth interviews with staff, conducted August 2015-March 2017.
METHODS: Three data sources: 1) detailed field notes, 2) observations using a structured tool and checklist for behaviors classed as agitation and staff and institutional responses, 3) staff semi-structured qualitative interviews. We calculated the time participants were agitated and described staff responses. Data sources were analyzed separately, developed continuously and relationally during the study and synthesized where appropriate.
RESULTS: We identified two main 'ideal types' of staff explanatory models for agitation: In the first, staff attribute agitated behaviors to the person's "moral judgement", making them prone to rejecting or punitive responses. In the second staff adopt a more "needs-based" approach in which agitation behaviors are regarded as meaningful and managed with proactive and investigative approaches. These different approaches appear to have significant consequences for the timing, frequency and quality of staff response. While these models may overlap they tend to reflect distinct organizational resources and values.
CONCLUSIONS: Care worker knowledge about agitation is not enough, and staff need organizational support to care better for people living with dementia towards end of life. Positional theory may help to explain much of the cultural-structural context that produces staff disengagement from people with dementia, offering insights on how agitation behavior is reframed by some staff as dangerous. Such behavior may be associated with low-resource institutions with minimal staff training where the personhood of staff may be neglected.

Origine : PubMed

Paradox of choice and the illusion of autonomy - the construction of ethical subjects in right-to-die activism

GANDSMAN, Ari
DEATH STUDIES, 2018, vol.42, n°5, p. 329-335

Moral frames for lives worth living - managing the end of life with dementia

LEMOS DEKKER, Natashe
DEATH STUDIES, 2018, vol.42, n°5, p. 322-328

In search of the good old life - ontological breakdown and responsive hope at the margins of life

GRON, Lone ; MATTINGLY, Cheryl
DEATH STUDIES, 2018, vol.42, n°5, p. 306-313

Death in life or life in death? - dementia’s ontological challenge

MACDONALD, Gaynor
DEATH STUDIES, 2018, vol.42, n°5, p. 290-297

Post-fordist death - a comparative ethnographic analysis of milling and mining in Northern England

DAWSON, Andrew ; GOODWIN-HAWKINS, Bryonny
DEATH STUDIES, 2018, vol.42, n°5, p. 282-289

Life’s end - ethnographic perspectives

GOODWIN-HAWKINS, Bryonny ; DAWSON, Andrew
DEATH STUDIES, 2018, vol.42, n°5, p. 269-274

Organizing end of life in hospital palliative care - a Canadian example

KRAWCZYK, Marian
Social science and medicine, 16/08/2019, Pagination inconnue

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Death and liminality - an ethnographic study of nursing home staff’s experiences in an encounter with the dead body

ADLAND, Anne Kristine ; LAVIK, Marta Høyland ; GRIPSRUD, Birgitta Haga ; RAMVI, Ellen
DEATH STUDIES, 09/08/2019, p. 1-11

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Challenges in delivering bad news in a multi-ethnic intensive care unit - an ethnographic study

VAN KEER, Rose-Lima ; DESCHEPPER, Reginald ; HUYGHENS, Luc ; BILSEN, Johan
Patient education and counseling, 28/06/2019, Pagination inconnue

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