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加拿大转移性乳腺癌女性患者临终前的生活经历:一项定性研究。第二部分——促成因素与抑制因素;临终准备的悖论

Lived experiences of Canadian women with metastatic breast cancer in preparation for their death: a qualitative study. Part II--enabling and inhibiting factors; the paradox of death preparation.

作者信息

Chunlestskul Kanoknuch, Carlson Linda E, Koopmans Janice P, Angen Maureen

机构信息

Faculty of Nursing, Burapha University, Thailand.

出版信息

J Palliat Care. 2008 Spring;24(1):16-25.

Abstract

OBJECTIVES

This study examined the essence of lived experiences of a sample of women with metastatic breast cancer in preparing themselves for their own death, with the goal of informing health provider interventions that support an acceptance of and preparation for death.

METHODS

A phenomenological qualitative approach was used. Five women with metastatic breast cancer were interviewed on two occasions. Themes were analyzed, described, and validated, until saturation was met. Qualitative outcomes of the thematic analysis related to the enabling and inhibiting factors involved in preparing for one's own death.

RESULTS

Factors that enabled and inhibited death preparation tasks in these women included: personal past death experiences; the availability of time and a place to think, learn, and work on death preparation activities; a chance to connect with others in similar situations; and personal and cultural attitudes towards death. Gaps and unmet needs within the health care system were identified. Finally, the paradoxical nature of various aspects of death preparation was highlighted.

CONCLUSIONS

Death preparation can be accomplished through enhancing supportive care from health care professionals, with beneficial outcomes for patients and families. Nurses should be conscious of the paradoxical nature of death preparation, and help women to confront and manage these.

摘要

目的

本研究探讨了转移性乳腺癌女性样本在为自己的死亡做准备时的生活体验本质,旨在为支持接受和准备死亡的医疗服务提供者干预措施提供信息。

方法

采用现象学定性研究方法。对五名转移性乳腺癌女性进行了两次访谈。对主题进行分析、描述和验证,直至达到饱和状态。主题分析的定性结果涉及为自己的死亡做准备的促进因素和抑制因素。

结果

这些女性中促进和抑制死亡准备任务的因素包括:个人过去的死亡经历;有时间和场所进行思考、学习以及开展死亡准备活动;有机会与处于类似情况的其他人建立联系;以及个人和文化对死亡的态度。确定了医疗保健系统中的差距和未满足的需求。最后,强调了死亡准备各方面的矛盾性质。

结论

通过加强医疗保健专业人员的支持性护理,可以完成死亡准备,这对患者和家庭有有益的结果。护士应意识到死亡准备的矛盾性质,并帮助女性面对和处理这些问题。

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