Ohlén Joakim, Andershed Birgitta, Berg Christina, Frid Ingvar, Palm Carl-Axel, Ternestedt Britt-Marie, Segesten Kerstin
Department of Nursing, Karolinska Institute, Stockholm, Sweden.
J Clin Nurs. 2007 Feb;16(2):382-90. doi: 10.1111/j.1365-2702.2006.01474.x.
To develop a goal-oriented praxis theory for enabling safety for relatives when an adult or older patient is close to end-of-life.
This is the second part of a project focusing on the situation and needs of relatives in end-of-life care. Our interpretation of the existing corpus of knowledge pertaining to the needs of close relatives in this situation showed the significance of relatives' need for safety.
The theory was developed step-by-step, through triangulation of critical review of empirical research in the field, our own clinical experiences from end-of-life care, renewed literature searches and theoretical reasoning.
The foundation for the theory is taken from the ethical intention of the philosopher Paul Ricoeur. From this, the theory focuses on relatives in the context of end-of-life care with the goal of enabling safety. This is proposed by four aphorisms functioning as safety enablers and these are directed towards the professional's approach and attitude, the relative's concern for the patient, the specific situation for the relative and the patient's end-of-life period as a period in the life of the relative.
Implications for end-of-life practice are considered and include aspects for promotion of just institutions in end-of-life care, the significance of negotiated partnership in end-of-life care, enabling safety for relatives living in existential and practical uncertainty in connection with end-of-life care and diversity of relatives' preferences as they live through this particular period.
构建一种以目标为导向的实践理论，以便在成年或老年患者接近生命末期时保障其亲属的安全。
这是一个关注临终关怀中亲属状况与需求项目的第二部分。我们对现有关于这种情况下亲属需求的知识体系进行解读后发现，亲属对安全的需求具有重要意义。
该理论通过对该领域实证研究的批判性综述、我们自身临终关怀的临床经验、重新进行的文献检索以及理论推理的三角互证逐步构建而成。
该理论的基础源自哲学家保罗·利科的伦理意图。据此，该理论聚焦于临终关怀背景下的亲属，目标是实现安全保障。这由四条作为安全促进因素的格言提出，这些格言针对专业人员的方法与态度、亲属对患者的关切、亲属与患者的具体情况以及患者生命末期作为亲属生命中的一个阶段。
考虑了对临终实践的影响，包括在临终关怀中促进公正机构建设的方面、临终关怀中协商伙伴关系的重要性、在临终关怀相关的生存和实际不确定性中保障亲属安全以及亲属在经历这一特殊时期时偏好的多样性。
