Department of Sociology, University of Manitoba, Winnipeg, Canada.
Sociol Health Illn. 2012 Sep;34(7):1010-24. doi: 10.1111/j.1467-9566.2011.01457.x. Epub 2012 Mar 5.
While there is a fair amount of knowledge regarding substantive features of end of life care that family members desire and appreciate, we lack full understanding of the process whereby family members formulate care evaluations. In this article we draw on an analysis of interview data from 24 bereaved family members to explicate how they interpret their experiences and formulate evaluations of end of life care services. Most participants wove between expressing and legitimising dissatisfaction, and qualifying or diffusing it. This occurred through processes of comparisons against prior care experiences and expectations, personalising (drawing on personal situations and knowledge), collectivising (drawing on conversations with and observations of others) and attempting to understand causes for their negative care experiences and to attribute responsibility. The findings suggest that dissatisfaction might be diffused even where care is experienced negatively, primarily through the acknowledgement of mitigating circumstances. To a lesser extent, some participants attributed responsibility to the 'system' (policy and decision-makers) and individual staff members. The findings are discussed in relation to the theoretical understanding of satisfaction and evaluation processes and how satisfaction data might inform improvements to care quality.
虽然对于临终关怀的实质性特征，家属有相当的了解和赞赏，但我们对家属制定护理评估的过程缺乏全面的理解。在本文中，我们借鉴了对 24 名丧亲家属的访谈数据的分析，阐述了他们如何解释自己的经历并对临终关怀服务进行评估。大多数参与者在表达和合法化不满，以及限定或化解不满之间摇摆。这是通过与之前的护理经历和期望进行比较、个性化（利用个人情况和知识）、集体化（利用与他人的对话和观察），以及试图理解负面护理经历的原因，并将责任归咎于他人的过程来实现的。研究结果表明，即使在护理体验不佳的情况下，不满也可能被淡化，主要是通过承认减轻情况的存在。在较小程度上，一些参与者将责任归咎于“系统”（政策和决策者）和个别工作人员。研究结果结合了对满意度和评估过程的理论理解，以及满意度数据如何为提高护理质量提供信息。
