title: [Struggling for normal in an instable situation - informal caregivers self-management in palliative home care. A meta-synthesis].
abstract: BACKGROUND
  Family caregivers play a key role in palliative home care for persons with advanced cancer. Although research has shown numerous burdens and strains of family caregiving, there is a lack of family-oriented support strategies in palliative home care. Little is known about family caregivers' self-management in this context so far. Qualitative research provides insight into families' perspectives of the transition to and management of palliative care at home and can be used as a starting point.
  
  
  OBJECTIVE
  The aim of the study was to increase knowledge of family caregivers' self-management in palliative home care by synthesizing evidence from qualitative research.
  
  
  METHODS
  Based on a systematic review of literature a meta-synthesis was conducted following the approach of Noblit and Hare (1988). A total of 13 qualitative studies from six countries, published from 2002 onward, formed the basis for an interpretative synthesis.
  
  
  RESULTS
  Caring for a person with advanced cancer at the end of life at home is characterized by an instable transition process in which families are 'struggling for normal'. Six different family self-management strategies to deal with this were identified: acknowledging the transition, restructuring everyday life, maintaining balance in family relationships, taking responsibility for care, using social support, and acquiring caring-skills.
  
  
  CONCLUSIONS
  Self-management strategies may provide a key for supporting family caregivers in palliative home care by focusing on resources and problem solving skills of families.
authors.affiliation: Department für Pflegewissenschaft und Gerontologie, UMIT - Private Universität für Gesundheitswissenschaften, medizinische Informatik und Technik, Hall in Tirol, Österreich.
authors.forename: Christiane
authors.initials: C
authors.lastname: Kreyer
authors.affiliation: Department für Pflegewissenschaft und Gerontologie, UMIT - Private Universität für Gesundheitswissenschaften, medizinische Informatik und Technik, Hall in Tirol, Österreich.
authors.forename: Sabine
authors.initials: S
authors.lastname: Pleschberger
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D002908:Chronic Disease / Q000451:nursing / Q000523:psychology; D017281:Cost of Illness; D006701:Home Nursing / Q000523:psychology*; D006801:Humans; D010166:Palliative Care / Q000523:psychology*; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000523:psychology; D012944:Social Support
keywords: Familie; Metasynthese; Palliative Care; Selbstmanagement; ambulante Pflege; family caregiving; meta-synthesis; palliative care; self-management