King's College London, Cicely Saunders Institute , Department of Palliative Care, Policy and Rehabilitation, London, United Kingdom.
J Palliat Med. 2011 Mar;14(3):343-9. doi: 10.1089/jpm.2010.0348. Epub 2011 Feb 9.
Although national findings regarding people's end-of-life care (EoLC) preferences and priorities are available within Europe, a lack of research coordination between countries has meant that cross-national understandings of EoLC remain unknown.
To (1) identify English and German understandings of EoLC within the context of an EoLC survey, and (2) to synthesise these understandings to aid interpretation of results from a cross-national survey.
An inductive and interpretive two-phased sequential design involving (1) qualitative analysis of cognitive interview data from 15 English and 15 German respondents to develop country-related categories, and (2) qualitative synthesis to identify a conceptually coherent understanding of EoLC.
Open and axial coding resulted in six English and six German categories. Commonalities included (a) the importance of social and relational dimensions, (b) dynamic decision making comprising uncertainty, (c) a valuing of life's quality and quantity, and (d) expectations for holistic care involving autonomy, choice, and timely information from trusted professionals. Differences involved attention to practical matters, and thoughts about prolongation of life, preferred place of death, and the role of media and context. Synthesis resulted in four concepts with underlying coherence: expectations of a high standard of EoLC involving autonomy, choice, and context; evolving decision making amid anticipated change; thoughts about living and existing; and worldviews shaping EoLC preferences in real and hypothetical scenarios.
Individual and country-related diversity must be remembered when quantifying EoLC understandings. Inductive-interpretive analysis of cognitive interview data aids interpretation of survey findings. Cross-national research coordination and qualitative synthesis assists EoLC in Europe.
尽管欧洲各国都有关于人们临终关怀（EoLC）偏好和优先事项的调查结果，但由于各国之间缺乏研究协调，因此对 EoLC 的跨国理解仍然未知。
（1）在 EoLC 调查的背景下，确定英语和德语对 EoLC 的理解；（2）综合这些理解，以帮助解释跨国调查的结果。
采用归纳和解释性的两阶段顺序设计，包括（1）对 15 名英国和 15 名德国受访者的认知访谈数据进行定性分析，以确定与国家相关的类别；（2）进行定性综合，以确定对 EoLC 的概念上一致的理解。
开放式和轴向编码产生了六个英语和六个德语类别。共同点包括（a）社会和关系维度的重要性；（b）包含不确定性的动态决策制定；（c）重视生命的质量和数量；（d）对涉及自主性、选择和及时获得信任的专业人员信息的整体护理的期望。差异涉及对实际问题的关注，以及对延长生命、首选死亡地点以及媒体和背景作用的思考。综合得出四个具有潜在一致性的概念：涉及自主性、选择和背景的高标准 EoLC 的期望；在预期变化中进行的演变决策；关于生活和存在的思考；以及在真实和假设情境中塑造 EoLC 偏好的世界观。
在量化 EoLC 理解时，必须记住个人和国家相关的多样性。通过对认知访谈数据进行归纳-解释性分析，可以帮助解释调查结果。跨国研究协调和定性综合有助于欧洲的 EoLC 研究。
