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丧亲亲属参与研究的潜在治疗价值:一项探索性研究。

The potential therapeutic value for bereaved relatives participating in research: An exploratory study.

作者信息

Germain Alison, Mayland Catriona R, Jack Barbara A

机构信息

Marie Curie Palliative Care Institute,Molecular and Clinical Cancer,University of Liverpool,Liverpool,United Kingdom.

Faculty of Health and Social Care,Edge Hill University,Ormskirk,United Kingdom.

出版信息

Palliat Support Care. 2016 Oct;14(5):479-87. doi: 10.1017/S1478951515001194. Epub 2015 Oct 29.

Abstract

OBJECTIVE

Conducting research with the bereaved presents an immediate ethical challenge, as they are undoubtedly a vulnerable group, associated with high levels of distress and susceptible to both physical and mental health issues. A comprehensive understanding of the potential therapeutic benefits for bereaved relatives participating in palliative care research is limited, and therefore the ethics of engaging this group remain questionable.

METHOD

This paper describes a secondary analysis of qualitative data collected in the Care of the Dying Evaluation (CODE) project, examining the experiences of patients who died at home. It explores the motivations and potential benefits for bereaved relatives participating in research with reference to the recently developed concepts in bereavement theory. Cognitive interviews were conducted with 15 bereaved relatives and secondary analysis using a content analysis framework was employed to classify the data.

RESULTS

The results center around six recurring concepts identified as adaptive in current bereavement theory: an opportunity to share the narrative accounts of the final hours of their relative's life; a search for sense and meaning in loss; an ongoing bond/attachment with the deceased; altruistic motivations; oscillation between loss and restorative orientations; and a sense of resilience. Overall, the participants found that taking part in the research was valuable and that it could be described as offering therapeutic benefits.

SIGNIFICANCE OF RESULTS

The need for bereaved relatives to take part in research studies should be encouraged, as they provide an accurate proxy for the patient's experience of end-of-life care while also providing a valuable account of their own perspective as family member and carer. In addition, we highlight the need for ethics committees to be aware of the potential benefits for bereaved relatives participating in research of this kind.

摘要

目的

对丧亲者进行研究面临着直接的伦理挑战,因为他们无疑是弱势群体,承受着高度的痛苦,且易出现身心健康问题。对于参与姑息治疗研究的丧亲亲属潜在的治疗益处,目前尚无全面的了解,因此让这一群体参与研究的伦理问题仍存疑问。

方法

本文描述了对“临终关怀评估”(CODE)项目中收集的定性数据进行的二次分析,该分析考察了在家中去世患者的经历。本文参照丧亲理论中最新提出的概念,探讨了丧亲亲属参与研究的动机和潜在益处。对15名丧亲亲属进行了认知访谈,并采用内容分析框架对数据进行二次分析以进行分类。

结果

结果围绕当前丧亲理论中被视为具有适应性的六个反复出现的概念展开:有机会分享其亲属生命最后时刻的叙述;在丧失中寻求意义;与逝者保持持续的联系/情感纽带;利他动机;在丧失与恢复取向之间摇摆;以及恢复力感。总体而言,参与者发现参与研究很有价值,且可将其描述为具有治疗益处。

结果的意义

应鼓励丧亲亲属参与研究,因为他们能准确代表患者临终关怀的体验,同时也能提供作为家庭成员和照顾者的宝贵观点。此外,我们强调伦理委员会需要意识到丧亲亲属参与此类研究的潜在益处。

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