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临终患者口服摄入:丧亲者观点的定性研究。

Bereaved relatives' perspectives of the patient's oral intake towards the end of life: a qualitative study.

机构信息

Department of Public Health, Erasmus MC, 3000 CA Rotterdam, the Netherlands.

出版信息

Palliat Med. 2013 Jul;27(7):665-72. doi: 10.1177/0269216313477178. Epub 2013 Feb 26.

DOI:10.1177/0269216313477178
PMID:23442880
Abstract

BACKGROUND

Patients approaching death often have a decreasing oral intake, which can be distressing for relatives. Little is known about the relatives' experiences with and perceptions of oral intake at the end of life.

AIM

This study aims to contribute to a more thorough understanding of relatives' concerns regarding decreased oral intake of the patient at the end of life.

DESIGN

Qualitative interview study: semi-structured interviews were transcribed verbatim and analysed using qualitative content analysis.

SETTING/PARTICIPANTS: Twenty-three bereaved relatives of patients who had been referred to a New Zealand palliative care service were interviewed.

RESULTS

All relatives experienced significant changes in patients' oral intake at the end of life. Oral intake towards the end of life was considered important and is perceived as meaningful by relatives in different ways, such as nutritional value, enjoyment, social time, daily routine and a way of caring. Relatives responded differently to decreasing oral intake; some accepted it as inherent to the dying process, others continued efforts to support the patient's oral intake. Some relatives perceived decreasing oral intake as the patient's choice, and some viewed maintaining oral intake as part of the battle against the disease. Relatives recalled limited communication with health-care professionals concerning oral intake at the end of life.

CONCLUSIONS

This study revealed the complexity of meaning relatives' experiences with dying patients' decreasing oral intake. Their perceptions and concerns were related to their awareness of the imminent death. These findings can guide staff involved in care delivery to better support relatives.

摘要

背景

接近死亡的患者常常会减少口腔摄入,这会令亲属感到痛苦。对于亲属在生命末期对患者口腔摄入减少的体验和看法,我们知之甚少。

目的

本研究旨在更深入地了解亲属对临终患者口腔摄入减少的担忧。

设计

定性访谈研究:对半结构化访谈进行逐字转录,并使用定性内容分析进行分析。

地点/参与者:对 23 位曾接受新西兰姑息治疗服务转诊的患者的丧亲亲属进行了访谈。

结果

所有亲属都经历了患者在生命末期口腔摄入的显著变化。临终时的口腔摄入被认为是重要的,并以不同的方式被亲属视为有意义,例如营养价值、享受、社交时间、日常生活和照顾方式。亲属对口腔摄入减少的反应不同;一些人接受它是死亡过程固有的,另一些人则继续努力支持患者的口腔摄入。一些亲属将减少口腔摄入视为患者的选择,而一些人则将维持口腔摄入视为对抗疾病的一部分。亲属回忆起与医疗保健专业人员就临终时的口腔摄入进行的有限沟通。

结论

本研究揭示了亲属对临终患者口腔摄入减少的体验的复杂性。他们的看法和担忧与他们对即将到来的死亡的意识有关。这些发现可以指导参与护理的工作人员更好地支持亲属。

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