Grande Gunn E, Farquhar Morag C, Barclay Stephen Ig, Todd Chris J
School of Nursing, Midwifery and Health, University of Manchester, Manchester, UK.
Br J Gen Pract. 2004 Oct;54(507):772-8.
Informal carers provide the bulk of palliative home care. They largely rely on general practitioners (GPs) and district nurses to support them in this role, yet little is known about what carers themselves consider important in this support.
To identify what informal carers valued in the palliative support provided by GPs and district nurses by using carers' own descriptions of such support.
Retrospective interviews.
Primary care in Cambridgeshire.
Semi-structured interviews with bereaved carers of 48 patients with cancer and 12 patients with non-cancer diagnoses. Content analysis of carers' evaluative descriptions of GP and district nurse support.
The accessibility of the GP and district nurse emerged as the most important aspect of support. Enlistment of help from other agencies was also extensively mentioned, together with provision of equipment. Attitude or approach during interactions, and relationship with the professional were important, particularly regarding GP support, whereas support for the carer, information, and symptom control were mentioned less often. Data suggested that support was not as good for older patients (> or =75 years), but this finding requires further investigation.
Results largely confirmed findings of previous, quantitative research and the importance of a patient-centred approach. What emerged most strongly, however, was the central importance of accessibility of support services for lay carers responsible for end-of-life home care. This mainly concerned GP and district nurse support, but accessibility of additional care and equipment were also important. In short, carers' main focus was the basic support that enabled them to sustain care in the home.
非正式护理人员提供了大部分的姑息性居家护理。他们在很大程度上依赖全科医生（GP）和社区护士来支持他们履行这一职责，然而对于护理人员自己认为这种支持中什么是重要的，我们却知之甚少。
通过使用护理人员对这种支持的自身描述，来确定非正式护理人员在全科医生和社区护士提供的姑息性支持中所重视的内容。
回顾性访谈。
剑桥郡的初级医疗保健机构。
对48名癌症患者和12名非癌症诊断患者的丧亲护理人员进行半结构化访谈。对护理人员对全科医生和社区护士支持的评价性描述进行内容分析。
全科医生和社区护士的可及性成为支持的最重要方面。广泛提到了从其他机构获得帮助以及提供设备。互动过程中的态度或方式以及与专业人员的关系很重要，特别是对于全科医生的支持而言，而对护理人员的支持、信息和症状控制则较少被提及。数据表明对老年患者（≥75岁）的支持不太理想，但这一发现需要进一步调查。
研究结果在很大程度上证实了先前定量研究的结果以及以患者为中心方法的重要性。然而，最突出的是，对于负责临终居家护理的非专业护理人员来说，支持服务的可及性至关重要。这主要涉及全科医生和社区护士的支持，但额外护理和设备的可及性也很重要。简而言之，护理人员的主要关注点是使他们能够在家中维持护理的基本支持。
