Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
DEATH WORK: STAFF PERSPECTIVES ON THE CARE OF TERMINALLY ILL PATIENTS IN AN ACUTE CARE HOSPITAL
Diss Abstr Int [A]; 51(3):1002 1990. Unique Identifier : AIDSLINE ICDB/90668578 Goodman HG; City Univ. of New York
Abstract:
This dissertation is a qualitative study of the perspectives of doctors, nurses, and social workers on terminally ill patients (pts) in their care. The methods used for this study were participant observation and focused interviews with professionals about dying pts whom they identified as difficult to manage. Fifteen pts were suggested, nine of whom had metastatic cancer and six of whom had AIDS. Eight physicians, ten nurses, and thirteen social workers were formally interviewed. The data for this study were collected in the mid-1980s at a prestigious medical center in a large urban city. The investigator was a research assistant with a medical service providing symptom management for dying pts in this hospital. A Typology of Ideal, Routine, and Toxic Pts was developed based on qualitative data gathered from this study. It describes three terminally ill pt types in relation to professional needs for cure or symptom amelioration, routinized work, and personal gratification. Ideal pts exceeded workers' expectations for response. Routine pts conformed to normative expectations and presented conventional problems. Toxic pts disrupted routines, had unattractive personal or disease characteristics, and questioned professional authority. Merton's theory of anomie (1968) was used to analyze professional responses associated with death work. Doctors and nurses were most frustrated when their curative interventions failed. Social workers found more goal congruity with death work and were frequently successful in supportive interventions with dying pts and their families. AIDS pts posed different problems for professionals than metastatic cancer pts. All professional groups were concerned about HIV exposure. The mass media were a major source of information even for highly educated professionals. Homophobic and punitive responses to AIDS pts were frequently observed and frankly expressed by several informants. Some staff stated that increased contact diminished homophobia. As with all dying pts, expressions of gratitude for staff efforts and/or heroic behavior earned AIDS pts and families the label of 'ideal.' The exploratory nature of this study, limited sample, and single study site make these findings only suggestive. Nevertheless, findings from this study point to the need for support of professional work with the dying, particularly in an environment of increasing numbers of AIDS pts. (Full text available from University Microfilms International, Ann Arbor, MI, as Order No. AAD90-20759)
Keywords: Acquired Immunodeficiency Syndrome/*PSYCHOLOGY *Attitude of Health Personnel *Attitude to Death Human Neoplasms/*PSYCHOLOGY Terminal Care/*PSYCHOLOGY THESIS 901230
M90C3717
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
