Notice bibliographique
Résumé
Background: Current demographic trends indicate that the annual number of expected deaths in Canada will double between 2005 and 2036, thus demanding further knowledge development to ensure quality end of life care in the future for an increasing part of the population. End of life care has evolved over time and continues to adapt to societal changes globally. In the western world, the current end of life care context is in flux, and the process of dying is becoming increasingly marginalized and viewed as a predominantly negative experience, both within the broad social and palliative care discourses. Positive concepts, such as joy, are understudied and often sidelined in the increasingly medicalized context of palliative and end of life care. To reclaim a more positive view of dying, and to improve the quality of life for individuals at the end of life, there is a need to forefront positive concepts, such as joy, in the context of end of life care. Purpose: The purpose of this dissertation was to explore the concept of joy in the context of the end of life and, more specifically, to better understand the experience of joy in adults with advanced cancer in hospice.Methods: The dissertation consists of four related and sequential papers: (1) a concept analysis of joy and happiness to determine the differences between the two concepts and to provide an initial definition of joy; (2) an integrative literature review of the "good death" in western society to explore how the dying process is represented and enacted in contemporary society and within the contemporary palliative care discourse; (3) a methods paper describing the role of transcripts in an interpretive description study; and (4) a findings paper describing a qualitative interpretive description study to understand the experience of joy from the perspective of adults with advanced cancer in the context of hospice.Findings and Conclusions: Dying in contemporary western society is portrayed as a predominantly negative process in both social and palliative care discourses. A contemporary "good death" ideally occurs without a dying process, as dying becomes less visible, more undesirable, in social discourse. But dying is undeniably an important part of living and as such, exploring and exposing positive dying experiences may help to reframe attitudes to dying and improve quality of life by improving end of life care. Although some research attention is given to positive concepts in palliative care, more emphasis needs to be given to concepts such as hope and joy, to reframe and reclaim the dying process.In this qualitative study, seven persons with advanced cancer residing in a hospice in an urban western Canadian city and six nurses were interviewed to explore the experience of joy in this population. Findings indicated that participants not only experienced joy at or near the end of life, but they valued their moments of joy, as these moments of joy made them feel connected, exhilarated, and alive. Participants described the experience of joy as a sudden "moment in time in which everything comes together" and form which comes strength, freedom, and the feeling of being alive. Participants associated joy with an intense feeling of deep connection. The findings of this study suggest that experiencing moments of joy may help patients feel cared for, alive, and connected to themselves and to others. Moments of joy may help those individuals with advanced illness who experience dislocation and alienation associated with liminality; joy may provide the connection that protects from despair and alienation and fosters healing. Based on my findings, I would like to encourage nurses who work in end of life settings or who study end of life issues to focus on providing more opportunities for individuals to experience joy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,013 | 0,020 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,005 | 0,004 |
| Études des sciences et des technologies | 0,011 | 0,034 |
| Communication savante | 0,011 | 0,010 |
| Science ouverte | 0,002 | 0,008 |
| Intégrité de la recherche | 0,002 | 0,006 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».