Munck Berit, Sandgren Anna, Fridlund Bengt, Mårtensson Jan
Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping, Sweden.
J Clin Nurs. 2012 Jul;21(13-14):1868-77. doi: 10.1111/j.1365-2702.2012.04123.x. Epub 2012 May 14.
Describe next-of-kin's conceptions of medical technology in palliative homecare.
Next-of-kin to palliative patients are in an exposed position with increasing responsibility. The more involved they are in the care, the greater caregiver burden they describe. Medical technology has become increasingly common in palliative homecare, and previous research suggests that the devices transform the homes to a hospital ward, thus shifting responsibility from the personnel to the next-of-kin.
An explorative descriptive design with a phenomenographic approach was chosen to describe qualitatively different conceptions of the phenomenon medical technology.
Interviews with 15 next-of-kin to patients in palliative homecare were analysed in a seven-step process where 10 conceptions emerged in five description categories.
Medical technology in palliative homecare required next-of-kin's responsibility in monitoring or providing practical help. It also implied uncertainty among the next-of-kin because of worries about its safety or because of an improper handling. The technology trespassed on daily life because it restricted and affected the private sphere. Medical technology enabled comfort as it implied security and was a prerequisite for the patient to be cared for at home. It also required an adjustment to comprehend and manage the medical technology.
Medical technology resulted in an increased caregiver burden and uncertainty among the next-of-kin. Although it meant restrictions and affected their social life, they had great confidence in its possibilities.
It is important to limit the amount of personnel and materials in the home to avoid trespassing on the family's daily life. Medical personnel also have to be sensitive to what next-of-kin have the strength to do and not use them as informal caregivers.
描述亲属对姑息性家庭护理中医疗技术的看法。
姑息治疗患者的亲属处于易受影响的位置,责任日益增加。他们参与护理的程度越高,所描述的护理负担就越大。医疗技术在姑息性家庭护理中越来越普遍,先前的研究表明,这些设备将家庭转变为医院病房,从而将责任从医护人员转移到亲属身上。
选择采用现象学方法的探索性描述性设计,以定性描述对医疗技术这一现象的不同看法。
对15名姑息性家庭护理患者的亲属进行访谈,并通过七个步骤进行分析,在五个描述类别中出现了10种看法。
姑息性家庭护理中的医疗技术要求亲属承担监测或提供实际帮助的责任。这也意味着亲属存在不确定性,因为担心其安全性或操作不当。该技术侵犯了日常生活,因为它限制并影响了私人领域。医疗技术带来了舒适感,因为它意味着安全,并且是患者能够在家中得到护理的先决条件。它还需要进行调整以理解和管理医疗技术。
医疗技术导致护理负担增加以及亲属的不确定性。尽管这意味着限制并影响了他们的社交生活,但他们对其可能性仍充满信心。
限制家中的人员和物资数量以避免侵犯家庭日常生活非常重要。医务人员还必须对亲属的能力敏感,不要将他们用作非正式护理人员。