Wallin Viktoria, Carlander Ida, Sandman P-O, Håkanson Cecilia
Department of Neurobiology,Care Science and Society,Karolinska Institutet,Stockholm,Sweden.
Palliative Research Centre,Ersta Sköndal University College and Ersta Hospital,Stockholm,Sweden.
Palliat Support Care. 2015 Oct;13(5):1231-9. doi: 10.1017/S1478951514001199. Epub 2014 Oct 22.
Food and eating are embedded in people's everyday social lives: at home with family members and as part of social interactions. For people with progressive life-limiting conditions, however, eating is often obstructed. The objective of the present study was to explore the meanings of living with eating deficiencies at the end of life among people admitted to specialist palliative home care.
This qualitative inductive study employed an interpretive descriptive approach. A dozen persons, with various diagnoses and eating deficiencies, admitted to two specialist palliative home care units, participated. Data were collected through individual repeated interviews. Data collection and analysis were guided by the interpretive description method.
The results reveal that eating deficiencies among people with progressive life-limiting conditions are existentially loaded markers of impending death. Finding ways to overcome declined food intake and hampered eating enabled our participants to feel able to influence their own well-being and remain hopeful. The results also showed that the eating deficiencies influenced participants' relationships and social interactions in ways that hampered their possibilities of sharing valuable moments together with friends and family members during the final period of life.
Efforts to minimize the distress that people experience in relation to the challenges they face with eating deficiencies are important for well-being at the end of life. Person-centered approaches to acknowledge and support individuals' own ways of experiencing and dealing with their eating deficiencies are recommended that include a multidimensional perspective on food and eating.
饮食与人们的日常社交生活紧密相连,无论是在家中与家人相处,还是作为社交互动的一部分。然而,对于患有进行性生命受限疾病的人来说,进食常常受到阻碍。本研究的目的是探讨在专科姑息家庭护理机构接受治疗的临终患者饮食不足的生活意义。
本定性归纳研究采用解释性描述方法。12名被收治到两个专科姑息家庭护理单元、患有各种诊断疾病且存在饮食不足的患者参与了研究。通过个体重复访谈收集数据。数据收集和分析以解释性描述方法为指导。
结果显示,患有进行性生命受限疾病的人的饮食不足是即将死亡的具有生存意义的标志。找到克服食物摄入量下降和进食困难的方法,使我们的参与者感到能够影响自己的幸福感并保持希望。结果还表明,饮食不足以某种方式影响了参与者的人际关系和社交互动,阻碍了他们在生命的最后阶段与朋友和家人共度珍贵时光的可能性。
努力将人们因饮食不足所面临的挑战而经历的痛苦降至最低,对于临终时的幸福感很重要。建议采用以人为本的方法来承认和支持个人体验和应对饮食不足的方式,其中包括对食物和饮食的多维视角。