Palliative Care Programme, Division of Family Medicine, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa.
J Pain Symptom Manage. 2013 Sep;46(3):386-94. doi: 10.1016/j.jpainsymman.2012.08.005. Epub 2012 Nov 11.
South Africa faces enormous HIV-related mortality and increasing cancer incidence. Traditional healers are the preferred source of advice and care in Africa, and this is true for the large Xhosa ethnic group.
To provide more appropriate multidimensional, culturally suitable care at the end of life; this study aimed to identify the care needs and cultural practices of Xhosa patients and families at the end of life, from the perspective of traditional healers.
The study design was qualitative and cross-sectional. The research took place in a 300 km radius around East London, Eastern Cape, South Africa. Interviewees were Xhosa individuals who were recognized by their communities as traditional healers. Data from two focus groups and eight individual interviews were analyzed, using an inductive thematic approach.
Data were elicited around the facilitation of a good death in terms of care needs before death and important rituals after death. Care needs before death focused on relief of psychosocial suffering; the importance of the spoken word at the deathbed; and the importance of a relationship and spiritual connection at the end of life. There were broad similarities across the rituals described after death, but these rituals were recognized to differ according to family customs or the dying person's wishes.
Awareness of potential needs at the end of life can assist clinicians to understand the choices of their patients and develop effective end-of-life care plans that improve the outcomes for patients and families.
南非面临着巨大的与艾滋病相关的死亡率和不断增加的癌症发病率。传统治疗师是非洲最受欢迎的咨询和护理来源，这对于庞大的科萨族群体来说也是如此。
在生命末期提供更适当的多维、文化适宜的护理；本研究旨在从传统治疗师的角度了解科萨族患者及其家属在生命末期的护理需求和文化习俗。
研究设计为定性和横断面研究。研究地点位于南非东开普省东伦敦周围 300 公里半径范围内。受访者是被他们的社区认可为传统治疗师的科萨人。使用归纳主题方法分析了来自两个焦点小组和八个个体访谈的数据。
研究结果围绕着在死亡前的护理需求和死后重要仪式方面促进一个好的死亡展开。死亡前的护理需求集中在缓解心理社会痛苦上；临终时言语的重要性；以及生命结束时的关系和精神联系的重要性。死后描述的仪式有很多相似之处，但这些仪式被认为因家庭习俗或临终者的意愿而异。
了解生命末期的潜在需求可以帮助临床医生了解患者的选择，并制定有效的临终关怀计划，从而改善患者和家庭的结局。
