Centre on Aging, University of Victoria, Victoria, British Columbia, Canada.
Palliat Support Care. 2009 Dec;7(4):435-47. doi: 10.1017/S1478951509990447.
When providing care for a loved one with a terminal illness, family members often look to health care providers for guidance and expertise. The objective of this study is to explore family caregiver accounts of their experiences within the health care system and with individual providers.
A thematic analysis of secondary qualitative data was performed. Data are from a subsample of bereaved and current family caregivers (N = 31) in a prior study of coping in end-of-life cancer situations. Data from these participants referring to experiences with health care providers was thematically coded and the concept of "security" was used as an analytic lens to facilitate conceptual development and exploration.
Considered together, the findings can be viewed as manifestations of a need and desire for security in palliative family caregiving. Specifically, family caregivers' accounts illustrate the importance of feeling secure that health care services will be provided by competent professionals; feeling secure in their timely access to needed care, services, and information; and feeling secure in their own identity and self-worth as a caregiver and individual. In addition, the findings suggest a conceptualization of security that extends beyond trust in individuals to include a generalized sense of institutional trust in the health care system.
The concept of security moves beyond description of individual satisfaction or dissatisfaction with health care to identify a common, foundational need underlying such evaluations. Further empirical research is needed that explicitly focuses on caregivers' experiences of security and insecurity in the domains identified in this article. This will contribute to theory building as well as assist in identifying the causes and consequences of security.
在照顾身患绝症的亲人时，家庭成员通常会寻求医疗保健提供者的指导和专业知识。本研究的目的是探讨家庭护理员在医疗保健系统中的体验，以及与个别提供者的关系。
对先前关于临终癌症情况应对研究中丧亲者和当前家庭护理员（N=31）的二次定性数据进行主题分析。这些参与者的数据涉及他们与医疗保健提供者的经历，并使用“安全性”这一概念作为分析视角，以促进概念的发展和探索。
综合来看，这些发现可以被视为姑息治疗中家庭护理需求和安全愿望的体现。具体而言，家庭护理员的叙述说明了以下几点的重要性：他们需要和希望确信医疗保健服务将由有能力的专业人员提供；能够及时获得所需的护理、服务和信息；以及在作为护理人员和个体的身份和自我价值感方面感到安全。此外，研究结果提出了一种安全性的概念化，这种概念化不仅包括对个人的信任，还包括对医疗保健系统的普遍机构信任。
安全的概念超越了对医疗保健满意度或不满度的描述，确定了这种评估背后的一个共同的、基础的需求。需要进一步进行明确关注护理员在本文所确定领域的安全和不安全体验的实证研究。这将有助于理论建设，并有助于确定安全的原因和后果。
