Meanings of being a close relative of a family member treated with haemodialysis approaching end of life
Article first published online: 9 MAY 2014
© 2014 John Wiley & Sons Ltd
Journal of Clinical Nursing
Volume 24, Issue 3-4, pages 447–456, February 2015
How to Cite
Axelsson, L., Klang, B., Lundh Hagelin, C., Jacobson, S. H. and Gleissman, S. A. (2015), Meanings of being a close relative of a family member treated with haemodialysis approaching end of life. Journal of Clinical Nursing, 24: 447–456. doi: 10.1111/jocn.12622
- Issue published online: 27 JAN 2015
- Article first published online: 9 MAY 2014
- Manuscript Accepted: 24 MAR 2014
- Sophiahemmet Foundation, Stockholm, Sweden
- Swedish Society of Nursing (SSF)
- close relative;
- end of life;
- end-stage renal disease;
- phenomenological hermeneutics;
- qualitative interviews;
- retrospective interviews
Aims and objectives
To describe and elucidate the meanings of being a close relative of a severely ill family member treated with maintenance haemodialysis approaching the end of life.
End-stage renal disease together with comorbidities, haemodialysis treatment and high mortality rates also affects the lives of close relatives, who report burdens and impaired quality of life. To improve care, more understanding is needed of close relatives' experiences during these patients' end of life.
This study has a qualitative interpretative design.
Fourteen retrospective qualitative interviews were conducted with close relatives (aged 48–93 years) of deceased patients who had been treated with haemodialysis. The interview text was interpreted using a phenomenological hermeneutical method in three phases.
The findings of the structural analysis were formulated as six themes: Striving to be supportive and helpful without doing harm to the ill person's self; Needing increasing strength and support; Balancing the will to help with one's own ongoing life; Increasing responsibility involving dilemmas; Striving for a good life together in the present and Living with awareness of death.
Close relatives strive for balance and well-being accompanying their ill family member through the end of life. They are facing moral dilemmas and growing demands as their responsibility increases with the deterioration of their family member. Support from and interaction with the healthcare professionals is then of significance.
Relevance to clinical practice
Findings challenge healthcare professionals in haemodialysis settings to identify close relatives' individual resources and needs towards the patients' end of life. Healthcare professionals in haemodialysis settings need to offer close relatives opportunities to talk about the future and what may be expected at end of life, with or without haemodialysis. They should also contact the closest relative after the death as they may need confirmation and closure.