Specialist Palliative Care Team, Betsi Cadwaladr University Health Board (Central Area), Bodelwyddan, UK.
North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK.
BMJ Support Palliat Care. 2020 Mar;10(1):e6. doi: 10.1136/bmjspcare-2016-001145. Epub 2017 Jan 16.
Supporting patients to die in the place of their choosing is an important aspect of end of life care. Our study set out to answer the question: 'How does the home environment influence perceptions of quality of death, and the experience of caring for the dying at home, for family carers and healthcare professionals (HCPs)?
A qualitative approach, using multiperspective interviews with bereaved family carers (n=15) and a nominated HCP (n=13) ensured depth of insight gained into supporting a home death. The semistructured interviews were audio recorded, transcribed verbatim and analysed using Framework.
We found that the home environment enabled normality, a sense of control and individualised care which family carers often perceived as contributing towards a good death. However, the home environment created challenges for both family carers and HCPs, due to the differing and at times conflicting needs of the dying person and their family carers.
We have shed light on the complexity of balancing the demands and the satisfaction of caring for someone dying at home. The ability to manage these conflicting needs influenced whether carers perceived the home setting as the best place for the person to have received care in their last days of life.
支持患者在其选择的地点去世是临终关怀的一个重要方面。我们的研究旨在回答以下问题：“家庭环境如何影响人们对死亡质量的看法，以及家庭护理人员和医疗保健专业人员（HCP）在家中照顾临终患者的体验？”
采用多视角访谈的定性方法，对 15 名丧亲的家庭护理人员（n=15）和 13 名指定的 HCP（n=13）进行了访谈，以深入了解支持在家中死亡的情况。对这些半结构化访谈进行了录音、逐字转录，并使用框架分析法进行了分析。
我们发现，家庭环境能够实现正常化、掌控感和个性化护理，家庭护理人员通常认为这有助于实现善终。然而，家庭环境给家庭护理人员和 HCP 带来了挑战，因为临终者及其家庭护理人员的需求存在差异，有时甚至相互冲突。
我们揭示了在家中照顾临终患者时平衡需求和满足需求的复杂性。管理这些冲突需求的能力影响了护理人员是否认为家庭环境是患者在生命最后几天接受护理的最佳场所。
