Department of Palliative Medicine, RWTH Aachen University, Aachen, Germany.
J Palliat Med. 2010 Aug;13(8):997-1003. doi: 10.1089/jpm.2010.0050.
The need for research methods that are suited to evaluate important issues and phenomena in palliative care has established different qualitative research approaches during the last years. This article describes the use and adaptation of a qualitative research methodology in a palliative care setting.
The wish for hastened death of terminally ill patients is an important end-of-life issue. Proponents of palliative care have argued that good palliative care would prevent the wish for hastened death. However, this wish is stated by a few patients receiving palliative care, raising a challenging dilemma for patients, relatives and caregivers involved. In order to investigate the motivations of the patients asking for hastened death, we conducted a qualitative study using Grounded theory (GT). This article aims to illustrate the use of a flexible, less burdening qualitative research method and the adaptation of the research process of GT in a palliative care research setting. This is based on experiences and illustrated by examples from the qualitative study on the wish for hastened death in patients receiving palliative care.
GT allowed a systematic understanding of patients' experiences and attitudes and careful in-depth exploration of this vulnerable population. Conducting a GT study needs high staff resources, a great catchment area for participant recruitment and realistic inclusion and exclusion criteria to allow for theoretical sampling. The use of GT should be facilitated by an experienced researcher familiar with this method because of high methodological requirements and rather complex analysis procedures.
需要研究方法来评估姑息治疗中重要的问题和现象，这在过去几年中确立了不同的定性研究方法。本文描述了一种定性研究方法在姑息治疗环境中的使用和适应。
终末期患者对加速死亡的渴望是一个重要的临终问题。姑息治疗的支持者认为，良好的姑息治疗可以防止加速死亡的愿望。然而，一些接受姑息治疗的患者表达了这种愿望，这给患者、亲属和护理人员带来了具有挑战性的困境。为了调查要求加速死亡的患者的动机，我们使用扎根理论（GT）进行了一项定性研究。本文旨在说明使用灵活、负担较小的定性研究方法以及在姑息治疗研究环境中适应 GT 研究过程的方法。这是基于经验，并通过姑息治疗中终末期患者对加速死亡的愿望的定性研究中的例子来说明。
GT 允许系统地理解患者的经验和态度，并对这一脆弱人群进行仔细的深入探索。进行 GT 研究需要大量的工作人员资源、广泛的参与者招募范围以及现实的纳入和排除标准，以允许进行理论抽样。由于方法要求高和分析程序复杂，应该由熟悉该方法的经验丰富的研究人员来促进 GT 的使用。
