Wittenberg-Lyles Elaine M, Thompson Sharlene
University of Texas, San Antonio, Department of Communication-M.B. 2.312, 6900 N. Loop 1604 W, San Antonio, TX 78249-0643, USA.
Am J Hosp Palliat Care. 2006 Aug-Sep;23(4):317-22. doi: 10.1177/1049909106289077.
Nonparticipant observation was undertaken to understand how barriers are discussed and managed in initial hospice enrollment conversations between patients, families, and hospice admission representatives. The first author observed patient/family and hospice admission representative interactions, interviewed hospice admission representatives, and attended monthly hospice meetings for a total of 37 hours of observation. Findings indicate that patients and a primary family member take on particular roles during these initial conversations. Based on the roles adopted by the patient and the family, the hospice admission representative engaged in 1 of 3 types of talk: (1) enrollment talk, (2) reassurance talk, or (3) informative talk. When engaging in enrollment conversations with families, hospice admission representatives direct their comforting statements toward reappraising uncertainty about hospice and uncertainty about death and dying.
采用非参与式观察来了解在患者、家属与临终关怀入院代表之间的初次临终关怀登记谈话中，障碍是如何被讨论和处理的。第一作者观察了患者/家属与临终关怀入院代表的互动，采访了临终关怀入院代表，并参加了每月的临终关怀会议，总计进行了37小时的观察。研究结果表明，在这些初次谈话中，患者和一名主要家庭成员会扮演特定的角色。根据患者和家属所扮演的角色，临终关怀入院代表会进行三种谈话类型中的一种：（1）登记谈话，（2）安慰谈话，或（3）信息谈话。在与家属进行登记谈话时，临终关怀入院代表会将他们的安慰性陈述指向重新评估对临终关怀的不确定性以及对死亡和临终的不确定性。
