Pflege
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Family caregivers play a key role in palliative home care for persons with advanced cancer. Although research has shown numerous burdens and strains of family caregiving, there is a lack of family-oriented support strategies in palliative home care. Little is known about family caregivers' self-management in this context so far. Qualitative research provides insight into families' perspectives of the transition to and management of palliative care at home and can be used as a starting point. ⋯ Self-management strategies may provide a key for supporting family caregivers in palliative home care by focusing on resources and problem solving skills of families.
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Advance directive is a contemporary issue because of accentuation of patients' autonomy and the increasing medical progress. But problems arise in drafting an advance directive as well as in realisation of advance directives in institutions. The duties and the influence of nursing in this context are hardly an object of scientific investigations. This article first describes empirically the role of nurses in connection with advance directives. ⋯ To avoid conflicts and to improve the handling and realisation of advance directives in practice it is recommendable to establish clinical ethical consultation. The tasks of the clinical ethical consultation are the creation and implementation of ethical directives in the institution, the realisation of individual case discussions and the ethical education of the affected health care professionals.
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In Germany, men participate more and more in the extensive process of caring for their relatives. ⋯ Caring husbands perceive and organise their wives' care situation individually. This includes their evaluation of professional assistance offers. Our findings point out the clear need for different offers of professional care givers when collaborating with caring husbands. Further research should focus on individual (long-time) care courses as well as reasons for declining professional assistance offers.