Background
Methods
Design
Participants
n | |
---|---|
Male | 1 |
Female | 13 |
Age | |
33–41 | 2 |
41–49 | 2 |
49–57 | 4 |
57–64 | 6 |
Experience of occupational therapy practice at present (2014) a | |
1–12 years | 4 |
12–23 years | 4 |
23–34 years | 1 |
34–44 years | 4 |
Experience of palliative care a | |
1–5 years | 1 |
5–10 years | 5 |
10–15 years | 4 |
15–25 years | 3 |
Healthcare context a | |
Urban home-care services | 5 |
Rural home-care services | 0 |
Nursing and care homes | 5 |
County council clinics | 4 |
Course in palliative care a | |
Yes | 10 |
Data collection
Data analysis
Meaning unit | Condensed meaning unit | Code | Subcategory | Category |
---|---|---|---|---|
And all the trips that are made too, I know when I was out there and we ... I, I still have an image in my head, we were out, now I can’t remember how, but it was in the final stages for those gentlemen that we took out to [place name], and they are sitting on a jetty with fishing rods with no hooks on but and smoking ci- ci- cigars, both those two gentlemen, it was kind of this quality of life. | Going on requested excursions at the end of life to have quality of life | Excursions that provide quality of life | Activity that provides quality of life | Activities based on the client’s wishes and possibilities |
But of course you notice this, we’ve got this personal, personal integrity, yes, that we talk about and you notice this of course, that they really want to manage this, especially going to the toilet by themselves, and they would like to manage all the personal things ... uh, if I’m to go and make an ADL assessment and that sort of thing, then I can, but of course I feel that it can feel awkward because they think they can feel ashamed that they can’t manage that particular thing themselves and that they want to manage all that, eating and drinking themselves, and going to the toilet and dressing themselves and taking care of their personal hygiene. | Dignity means that the person wants to manage personal tasks independently | Personal activities to maintain dignity | Activity to maintain dignity |
Results
Categories | Activities based on the client’s wishes and circumstances | Prioritizing activities together with the client | Facilitating factors to enable activity for clients in palliative care | Limiting factors to enable activity for clients in palliative care | Areas for improvement to enable activity |
Subcategories | Activity to get away from the care environment Important to return home Activities that require little energy Activity for reflection and support Activity to maintain physical ability Fulfilling responsibilities Conversation Carrying on as usual Being included in activities Planning the activity themselves Activity to maintain integrity Participating in group activities Individual activity Activities that give quality of life Not wanting or managing activity | Activity depending on the client’s wishes and motivation Focusing on remaining health through activity Customizing activities to the person and context The client’s physical ability influences the choice of activity Activity to allow social interaction Taking relatives into account when planning activity | A client with a positive attitude and motivation Clients with good communication skills A team that is in consensus Physical factors in the environment | Limitations in the physical environment Lack of cooperation Establishing contact at a late phase Lack of resources Clients with a negative attitude or impaired insight Lack of communication with the client The client’s physical limitations due to illness Staff who follow written procedures rather than being responsive to the client’s needs Clients with a negative attitude to aids Negative consequences of activity | Need nearby premises for activities Need to talk more Need more time for activities Find new ways to bring clients together for activities |
Enabling activities based on the client’s wishes and circumstances
Occupational therapist 9: “We had a man who summoned his energy because he had to get out and sell his car so that his wife would not have to trouble herself with that. Many are worried about their relatives, about what will happen, and such things. So he really made an effort, and then he was off and dealt with getting rid of the car. It was like he had it on his mind for a few weeks: that it was an important thing for him to get done.”
Occupational therapist 8: “Most of the time, it is the older generation of men who have had the responsibility for everything. And as you say, nobody else should be troubled with that.” (Focus group 2)
Prioritizing activities together with the client
Occupational therapist 2: “I think that I probably enable it in that I’m fast, so to say. If it is about an aid to be able to enable an activity, an office chair to allow someone to be active… you give it priority, and you take that step before you might have done it for a different client. In that case, you would have waited, … but it’s not like that in this case; here, you don’t hesitate.”
Occupational therapist 6: “It’s a good thing when seriously ill clients have a request; if they want to come home, we have to act right now because in two days, it may be too late.” (Focus group 1)
Occupational therapist 8: “Sometimes relatives come, and it can be surprising because then it can suddenly be things that can appeal to them; it gains a context. Unwinding in front of the TV with the family on Friday nights is one such thing, which can consist of a bit of this and that, like crisps and dip, and, yes, a little wine and all that, and it can be appealing, you know.” (Focus group 2)
Facilitating factors to enable activity for clients in palliative care
Limiting factors to enable activity for clients in palliative care
Occupational therapist 6: “... she doesn’t want to accept it: ‘I'm not old, I don’t want to be handicapped, and these people will of course laugh at me’.” (Focus group 1)