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追求独立:患有生命受限疾病的服务使用者的经历与需求。

Striving for independence: experiences and needs of service users with life limiting conditions.

作者信息

Cotterell Phil

机构信息

Health and Social Policy Research Centre, School of Applied Social Science, University of Brighton, Brighton, UK.

出版信息

J Adv Nurs. 2008 Jun;62(6):665-73. doi: 10.1111/j.1365-2648.2008.04638.x.

Abstract

AIM

This paper is a report of a study to explore what service users with a range of life-limiting conditions identify as their key experiences and needs generally and, specifically, from health and social care services.

BACKGROUND

Whilst internationally palliative care has a primary focus on service users who have cancer, there is growing evidence that those with non-cancer life-limiting conditions have similar palliative care needs. The literature has mainly been focused on independence, choice and control at an individual level, with wider influences on the maintenance or attainment of independence ignored.

METHOD

A participatory approach was used in 2003-2004, with both the researcher and a group of service users working together in all stages of the study. Twenty-five participants in receipt of support from an acute hospital, primary care, social services and a hospice took part. Face-to-face individual interviews and small discussion groups were conducted and data were analysed thematically.

FINDINGS

Eight different but interconnected themes were identified. Independence/dependence was an overarching theme, with negotiation between independence and dependence being evident across all themes. This theme and the influence of health and social care services on the experience of living with life-limiting conditions are the focus of this paper.

CONCLUSION

Palliative care and practitioners should focus on maximizing independence at both the individual and structural levels. How services for those with life-limiting conditions are provided and relationships with health and social care staff can directly impact on an individual's experience of independence, choice and control.

摘要

目的

本文是一项研究报告,旨在探究患有一系列生命受限疾病的服务使用者普遍认为的关键经历和需求,特别是在健康和社会护理服务方面的需求。

背景

在国际上,姑息治疗主要关注癌症患者,但越来越多的证据表明,患有非癌症生命受限疾病的患者也有类似的姑息治疗需求。文献主要集中在个体层面的独立性、选择和控制权,而对维持或实现独立性的更广泛影响则被忽视。

方法

2003年至2004年采用了参与式方法,研究人员和一组服务使用者在研究的各个阶段共同合作。25名接受急性医院、初级保健、社会服务和临终关怀支持的参与者参与了研究。进行了面对面的个人访谈和小型讨论小组,并对数据进行了主题分析。

结果

确定了八个不同但相互关联的主题。独立/依赖是一个总体主题,在所有主题中,独立与依赖之间的协商都很明显。本文重点关注这一主题以及健康和社会护理服务对患有生命受限疾病的生活体验的影响。

结论

姑息治疗及从业者应在个体和结构层面上致力于最大限度地提高独立性。为生命受限患者提供服务的方式以及与健康和社会护理人员的关系会直接影响个人的独立、选择和控制体验。

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