University at Buffalo School of Social Work, Buffalo, New York 14260, USA.
J Pain Symptom Manage. 2012 Feb;43(2):182-94. doi: 10.1016/j.jpainsymman.2011.04.017.
Family members of people with advanced cancer can experience intensified distress and uncertainty during the final stages of their loved one's illness. Enhanced comprehension about disease progression, symptom management, and options for care can help families adapt, cope, and plan for the future.
Guided by concepts from the Sense of Coherence Theory, which illuminates factors that contribute to adaptation in stressful situations, the objective of this study was to explore and describe family caregivers' accounts of the nature and timing of communication they had with a loved one's health care provider(s) during the advanced stages of cancer and before hospice enrollment.
Retrospective in-depth interviews were conducted with caregivers of 46 people who died of cancer. Interviews were audiotaped, transcribed, and submitted to an iterative process of qualitative data analysis that included 1) systematic coding, 2) the use of data matrices to display summarized results and collapse the codes into themes, 3) and axial coding to characterize the nature of the themes.
Overall, communication with providers was found to be either 1) satisfactory or 2) unsatisfactory. Satisfactory communication was 1) compassionate, 2) responsive, and/or 3) dedicated. Unsatisfactory communication was described as 1) sparse, 2) conflicted, 3) contradictory, and/or 4) brink of death.
Communication with health care providers is critical for helping family caregivers understand and manage the changes that accompany a life-limiting illness. Timely communication with information and meaningful discussion about disease progression can help families prepare for the advanced stages of an illness and approaching death.
晚期癌症患者的家属在亲人患病的最后阶段可能会经历更强烈的痛苦和不确定性。增强对疾病进展、症状管理和护理选择的理解，可以帮助家庭适应、应对并规划未来。
本研究以意识连贯理论的概念为指导，该理论阐明了在压力情况下适应的因素，旨在探讨和描述癌症晚期和临终关怀登记前，家庭成员与亲人的医疗保健提供者之间沟通的性质和时间。
对 46 名因癌症去世的患者的照顾者进行了回顾性深入访谈。访谈进行了录音、转录，并提交给一个迭代的定性数据分析过程，包括 1）系统编码，2）使用数据矩阵显示总结结果并将代码压缩为主题，3）轴向编码以描述主题的性质。
总体而言，与提供者的沟通要么是 1）满意的，要么是 2）不满意的。满意的沟通是 1）富有同情心的，2）响应性的，和/或 3）专注的。不满意的沟通被描述为 1）稀疏的，2）冲突的，3）矛盾的，和/或 4）濒死的。
与医疗保健提供者的沟通对于帮助家庭照顾者理解和管理伴随生命有限疾病的变化至关重要。及时与信息沟通，并就疾病进展进行有意义的讨论，可以帮助家庭为疾病的晚期和临近死亡做好准备。
