Giesbrecht Melissa, Wolse Faye, Crooks Valorie A, Stajduhar Kelli
Simon Fraser University,Burnaby,British Columbia,Canada.
University of Victoria,Victoria,British Columbia,Canada.
Palliat Support Care. 2015 Jun;13(3):555-65. doi: 10.1017/S1478951513001028. Epub 2013 Nov 11.
In Canada, friends and family members are becoming increasingly responsible for providing palliative care in the home. This is resulting in some caregivers experiencing high levels of stress and burden that may ultimately surpass their ability to cope. Recent palliative care research has demonstrated the potential for caregiver resilience within such contexts. This research, however, is primarily focused on exploring individual-level factors that contribute to resilience, minimizing the inherent complexity of this concept, and how it is simultaneously influenced by one's social context. Therefore, our study aims to identify socio-environmental factors that contribute to palliative family caregiver resilience in the Canadian homecare context.
Drawing on ethnographic fieldnotes and semistructured interviews with family caregivers, care recipients, and homecare nurses, this secondary analysis employs an intersectionality lens and qualitative case study approach to identify socio-environmental factors that facilitate family caregivers' capacity for resilience. Following a case study methodology, two cases are purposely selected for analysis.
Findings demonstrate that family caregiver resilience is influenced not only by individual-level factors but also by the social environment, which sets the lived context from which caregiving roles are experienced. Thematic findings of the two case studies revealed six socio-environmental factors that play a role in shaping resilience: access to social networks, education/knowledge/awareness, employment status, housing status, geographic location, and life-course stage.
Findings contribute to existing research on caregiver resilience by empirically demonstrating the role of socio-environmental factors in caregiving experiences. Furthermore, utilizing an intersectional approach, these findings build on existing notions that resilience is a multidimensional and complex process influenced by numerous related variables that intersect to create either positive or negative experiences. The implications of the results for optimizing best homecare nursing practice are discussed.
在加拿大，朋友和家庭成员在家庭中提供姑息治疗的责任越来越大。这导致一些护理人员承受着高水平的压力和负担，最终可能超出他们的应对能力。最近的姑息治疗研究表明，在这种情况下护理人员具有恢复力的潜力。然而，这项研究主要集中在探索有助于恢复力的个人层面因素，将这一概念的内在复杂性降至最低，以及它如何同时受到个人社会环境的影响。因此，我们的研究旨在确定在加拿大家庭护理背景下有助于姑息家庭护理人员恢复力的社会环境因素。
利用民族志田野笔记以及对家庭护理人员、护理对象和家庭护理护士的半结构化访谈，这项二次分析采用交叉性视角和定性案例研究方法来确定有助于家庭护理人员恢复力的社会环境因素。遵循案例研究方法，特意选择两个案例进行分析。
研究结果表明，家庭护理人员的恢复力不仅受到个人层面因素的影响，还受到社会环境的影响，社会环境设定了体验护理角色的生活背景。两个案例研究的主题结果揭示了六个在塑造恢复力方面发挥作用的社会环境因素：获得社交网络、教育/知识/意识（水平）、就业状况、住房状况、地理位置和人生阶段。
研究结果通过实证证明社会环境因素在护理经历中的作用，为现有的护理人员恢复力研究做出了贡献。此外，利用交叉性方法，这些结果建立在现有观念的基础上，即恢复力是一个多维且复杂的过程，受到众多相关变量的交叉影响，这些变量相互作用产生积极或消极的体验。讨论了研究结果对优化最佳家庭护理实践的影响。
