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在姑息治疗中理解健康和疾病:志愿者的观点。

Making sense of health and illness in palliative care: volunteers' perspectives.

机构信息

Département de Médecine Familiale et de Médecine d'Urgence, Université Laval, Québec, Canada.

出版信息

Palliat Support Care. 2010 Sep;8(3):325-34. doi: 10.1017/S147895151000012X.

Abstract

OBJECTIVE

To encourage communication and contribute to the palliative care movement's need for interdisciplinary care, this article offers to explore the stance of volunteers on two fundamental concepts, "health" and "illness," as well as their related understanding of "palliative care." Volunteers' understandings are then compared with the concepts put forth by the Canadian Hospice Palliative Care Association (CHPCA) in its "Model to Guide Hospice Palliative Care."

METHOD

Focus groups with volunteers, and individual interviews with coordinators from five selected palliative care community action organizations from across Canada, are used. A total of 65 participants from three Canadian provinces were interviewed.

RESULTS

Participants view illness as a subjective, multidimensional, and transformative experience that requires multiple adjustments. It is an impediment to personal equilibrium and a challenge for the terminally ill and their close ones. Health, on the other hand, is a complex phenomenon that consists of physical, psychological, social, and spiritual well-being. For participants, health is most often embodied by a person's capacity to adjust to their challenging circumstances. Both volunteers and coordinators see palliative care as an alternative approach to care that centers on helping patients and their families through their ordeal by offering comfort and respite, and helping patients enjoy their life for as long as possible.

SIGNIFICANCE OF RESULTS

Participants describe illness as a destabilizing loss and palliative care as a means to compensate for the numerous consequences this loss brings; their actions reflect these principles and are compatible with the CHPCA model.

摘要

目的

为了促进交流,为缓和医疗运动对跨学科护理的需求做出贡献,本文旨在探讨志愿者对两个基本概念——“健康”和“疾病”,以及他们对“缓和医疗”的相关理解的立场。然后将志愿者的理解与加拿大善终关怀协会(CHPCA)在其“指导善终关怀模式”中提出的概念进行比较。

方法

使用来自加拿大五个选定的姑息治疗社区行动组织的志愿者焦点小组和协调员的个人访谈。来自三个加拿大省份的 65 名参与者接受了采访。

结果

参与者将疾病视为一种主观的、多维的、变革性的体验,需要进行多次调整。它是个人平衡的障碍,也是绝症患者及其家属的挑战。另一方面,健康是一个复杂的现象,包括身体、心理、社会和精神健康。对参与者来说,健康通常是一个人适应挑战环境的能力的体现。志愿者和协调员都将姑息治疗视为一种替代护理方法,通过提供安慰和缓解,帮助患者及其家属度过难关,并帮助患者尽可能长时间地享受生活。

结果的意义

参与者将疾病描述为一种不稳定的丧失,而姑息治疗则是一种补偿这种丧失带来的众多后果的手段;他们的行动反映了这些原则,与 CHPCA 模式是一致的。

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