Date of Award

2006

Degree Type

Thesis

Degree Name

Master of Science in Nursing

Program

Nursing

Supervisor

Dr. Catherine Ward-Griffin

Abstract

During the past two decades, social, political and economic reform has been a driving force of healthcare change. Healthcare restructuring, typified by shortened lengths of hospital stays and reduced number of acute care beds has shifted care from hospital to home (Frankman, 1998; LeClerc, Wells, Craig & Wilson, 2002). Included in this transition to home-based care is the downloading of the delivery of palliative care (Cartier, 2003). Although a number of studies have explored home-based palliative care, little is known about the contextual factors within this care setting and how they may constitute the nurse-client relationship. This qualitative secondary analysis was an analytic expansion (Thorne, 1998) of data generated from 19 in-depth interviews with three community nurses who participated in a previous ethnographie, longitudinal study of client-caregiver-nurse relationships in home-based palliative care for seniors (Ward Griffin & McWilliam, 2004). Study findings revealed three evolving phases within the nurse-client relationship: approaching, being there and withdrawing. Movement from one phase of the relationship to another occurred within the context of various intrinsic and extrinsic factors of home-based palliative care. In light of the unrelenting growth in home-based palliative care, these findings have significant implications for nursing educators, palliative care program planners and community nursing agency personnel.

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