För att utföra en säker palliativ vård i hemmet är det viktigt med kontinuitet bland personalen vilket också skapar en trygghet hos familjen.
Vid planering av palliativ vård i hemmet med endast en närstående vårdare är det viktigt att övertyga familjen att acceptera hjälp från hemtjänst annars är risken att vården i hemmet avbryts.
Då familjer bor långt borta får de inte känna sig tvingade att hjälpa till med medicintekniken, utan delaktigheten i vården måste vara på deras egna villkor.
Om distriktssköterskor ska klara av att hantera medicinteknik i hemmet utan att känna osäkerhet, behövs regelbunden träning på befintlig teknik samt att de specialiserar sig mer inom palliativ vård. Det är viktigt att utveckla stödgrupper för närståendevårdare med
speciellt utformade program som behandlar deras behov.
Mer forskning behövs om distriktssköterskornas utsatthet inom palliativ vård i hemmet
Med begreppet palliativ hemsjukvård som en trygghetsbas behövs mer forskning om vilka förbättringar som är viktiga när medicinteknik förekommer i palliativ hemsjukvård.
68
Acknowledgements
This thesis was made possible by financial support from Futurum- the Academy for Healthcare, County Council, Jönköping - The Research Council of Southeastern Sweden (FORSS) - Association of Cancer, County Council, Jönköping, - Ulrica Cronér Fund - Association of District Nurses in Sweden.
I would like to express my sincere gratitude to all who have contributed to this thesis by sharing experiences and knowledge and in a variety of ways supported me throughout this work. In particular, I would like to give a special thanks to the following:
Thanks to all patients, next-of-kin and district nurses who have participated in the studies. Thank you for so willingly sharing your experiences and thoughts, thereby making this thesis possible.
Professor Jan Mårtensson, my main supervisor. Thank you for always believing in my ability to do this thesis. Thanks for excellent scientific guidance, encouragement, engagement and constructive criticism of my manuscripts, for being so accessible and for your always quick feedback. Professor Bengt Fridlund, my assistant supervisor and co-author. Thanks for your encouraging and optimistic attitude. Thanks for your excellent
scientific guidance, constructive criticism, all your good advice and your ability to always find solutions when obstacles arise.
PhD Anna Sandgren, my assistant supervisor and co-author. Thank you for sharing your expertise in the field and for all invaluable comments and critical reviews of my manuscripts regarding grammar.
Jan and Pearl Ohlsson. Thanks for your skilful revision of the English language
69
All colleagues who helped me to get into contact with potential participants. My colleagues at the Department of Nursing Science, School of Health Sciences, Jönköping University for all your encouragement.
PhD students and staff at the School of Health Sciences, Jönköping University for valuable criticism and discussions during the seminars.
All colleagues and friends at Skillingaryd’s Health Care Center and Vaggeryd’s Home Healthcare for managing the daily work when I, as your manager, studied palliative care in San Francisco.
Anne Hughes. Thanks for the unforgettable days when you took the time and showed me palliative care in San Francisco. Hope to see you again. I still owe you a lunch.
Ann-Sofie Scheel. Thanks for your interest and for our fruitful discussions about phenomenography on our trips to Halmstad University.
Thanks to my loving husband Jonas, for all the support and understanding you have given me throughout these years. Thank you for having patience with a distracted wife.
Thanks to my dear son Pontus for computer support when I needed it. Thank you for always being helpful and driving me and your father to the airport when I travelled away for analysis of the interviews.
Thanks to my dear daughter Karolina for help with illustrating the figures and for all the pleasant lunches we had together discussing my work.
My dear sister Kerstin thanks for your support and your pride in me. My uncle Erik thanks for your interest and encouragement.
My friends Kristina, Majsan, Pia, Agneta, Gunnel and Eva for getting me to think about other things than my research.
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71
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