title: What is a 'secure base' when death is approaching? A study applying attachment theory to adult patients' and family members' experiences of palliative home care.
abstract: OBJECTIVE
  Attachment theory has received much interest lately in relation to how adults cope with stress and severe illness. The aim of this study was using the experiences of patients and family members to explore palliative home care as a 'secure base' (a central concept within the theory).
  
  
  METHODS
  Twelve patients and 14 family members were interviewed during ongoing palliative home care. The interviews were analysed with deductive qualitative content analysis.
  
  
  RESULTS
  Informants expressed the relevance of sensing security during palliative home care because death and dying were threats that contributed to vulnerability. Palliative home care could foster a feeling of security and provide a secure base. This was facilitated when informants had trust in staff (e.g. due to availability and competence in providing symptom relief), felt recognised as individuals and welcomed to contact the team in times of needs. Being comfortable, informed and having an everyday life also contributed to a perception of palliative home care as a secure base. Family members stressed the importance of being relieved from responsibilities that were too heavy. The underlying meanings of experiencing palliative home care as a secure base involved gaining a sense of control and of inner peace, perceiving that despite a demanding and changed life situation, one could continue partially being oneself and having something to hope for, even if this no longer concerned cure for the ill person.
  
  
  CONCLUSIONS
  Important aspects of palliative home care as providing a secure base were identified and these have implications for clinical practice.
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden; LAH/Unit of Palliative Care, University Hospital, Linköping, Sweden; Palliative Education and Research Centre in the County of Östergötland, Norrköping, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Milberg
authors.forename: R
authors.initials: R
authors.lastname: Wåhlberg
authors.forename: M
authors.initials: M
authors.lastname: Jakobsson
authors.forename: E-C
authors.initials: EC
authors.lastname: Olsson
authors.forename: M
authors.initials: M
authors.lastname: Olsson
authors.forename: M
authors.initials: M
authors.lastname: Friedrichsen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005190:Family / Q000523:psychology*; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D009769:Object Attachment; D010166:Palliative Care / Q000523:psychology*; D011582:Psychological Theory; D036301:Qualitative Research