Bleidorn J, Pahlow H, Klindtworth K, Schneider N
Institut für Allgemeinmedizin, Medizinische Hochschule Hannover.
Dtsch Med Wochenschr. 2012 Jun;137(25-26):1343-8. doi: 10.1055/s-0032-1305045. Epub 2012 Jun 12.
Within end-of-life care concepts, relatives of patients suffering from incurable illness are an important target group. This study aims to explore the experiences of relatives of deceased patients regarding health care delivery within the last days and weeks of life, and to work out implications for patient and relatives oriented improvement strategies.
We conducted 19 qualitative interviews with bereaved relatives addressing the patient's use of health care services and satisfaction with the services, as well as communication and information. Interviews were transcribed verbatim and analyzed using qualitative content analysis.
Three main categories were developed: (1) present health care delivery, e. g. positive and negative experiences concerning communication and information; (2) expectations and wishes, e. g. better support and coordination concerning discharge from hospital; (3) the relative and the dying patient, e. g. attitudes towards death and dying as well as individual limitations and resources. Overall, from the perspective of the bereaved relatives there are deficits concerning coordination of health care delivery and communication.
Improving coordination of health care in particular with regard to the interfaces of outpatient and inpatient care, advanced care planning and strengthening "talking medicine" may contribute to optimize health care delivery for severely ill and dying patients and their relatives.
在临终关怀理念中，身患绝症患者的亲属是重要的目标群体。本研究旨在探究已故患者亲属在患者生命最后几天和几周内接受医疗服务的经历，并制定以患者和亲属为导向的改进策略的相关启示。
我们对丧亲亲属进行了19次定性访谈，内容涉及患者对医疗服务的使用情况、对服务的满意度以及沟通与信息交流。访谈内容逐字转录，并采用定性内容分析法进行分析。
形成了三大主要类别：（1）当前的医疗服务提供情况，例如关于沟通与信息交流的正面和负面经历；（2）期望与愿望，例如在出院方面获得更好的支持与协调；（3）亲属与临终患者，例如对死亡和临终的态度以及个人的局限与资源。总体而言，从丧亲亲属的角度来看，医疗服务提供的协调和沟通存在不足。
改善医疗服务的协调，特别是在门诊与住院护理的衔接、临终关怀规划以及加强“对话式医疗”方面，可能有助于优化为重症和临终患者及其亲属提供的医疗服务。
