Kreyer Christiane, Pleschberger Sabine
Department für Pflegewissenschaft und Gerontologie, UMIT - Private Universität für Gesundheitswissenschaften, medizinische Informatik und Technik, Hall in Tirol, Österreich.
Pflege. 2014 Oct;27(5):307-24. doi: 10.1024/1012-5302/a000378.
Family caregivers play a key role in palliative home care for persons with advanced cancer. Although research has shown numerous burdens and strains of family caregiving, there is a lack of family-oriented support strategies in palliative home care. Little is known about family caregivers' self-management in this context so far. Qualitative research provides insight into families' perspectives of the transition to and management of palliative care at home and can be used as a starting point.
The aim of the study was to increase knowledge of family caregivers' self-management in palliative home care by synthesizing evidence from qualitative research.
Based on a systematic review of literature a meta-synthesis was conducted following the approach of Noblit and Hare (1988). A total of 13 qualitative studies from six countries, published from 2002 onward, formed the basis for an interpretative synthesis.
Caring for a person with advanced cancer at the end of life at home is characterized by an instable transition process in which families are 'struggling for normal'. Six different family self-management strategies to deal with this were identified: acknowledging the transition, restructuring everyday life, maintaining balance in family relationships, taking responsibility for care, using social support, and acquiring caring-skills.
Self-management strategies may provide a key for supporting family caregivers in palliative home care by focusing on resources and problem solving skills of families.
家庭照护者在晚期癌症患者的姑息居家照护中发挥着关键作用。尽管研究表明家庭照护存在诸多负担和压力，但姑息居家照护中缺乏以家庭为导向的支持策略。到目前为止，在这种背景下，对于家庭照护者的自我管理知之甚少。定性研究能够深入了解家庭对于居家姑息照护的过渡和管理的看法，并可作为一个起点。
本研究的目的是通过综合定性研究的证据，增加对姑息居家照护中家庭照护者自我管理的认识。
基于对文献的系统回顾，按照诺布利特和黑尔（1988年）的方法进行了元综合分析。从2002年起发表的来自六个国家的总共13项定性研究构成了诠释性综合分析的基础。
在家中照顾临终晚期癌症患者的特点是过渡过程不稳定，在此过程中家庭“努力维持正常状态”。确定了六种不同的家庭自我管理策略来应对这一情况：承认过渡、重新安排日常生活、维持家庭关系平衡、承担照护责任、利用社会支持以及获得照护技能。
自我管理策略可能为支持姑息居家照护中的家庭照护者提供关键，其重点在于家庭的资源和解决问题的能力。
